Browse > Article

Two Cases of Fatal Hypoxemia after Talc Pleurodesis for Recurrent Malignant Pleural Effusion  

Park, Shin Ae (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Lee, Han Hee (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Kim, Dae Jun (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Shim, Byoung Yong (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Song, So Hyang (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Kim, Chi Hong (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Ahn, Myeong Im (Lung Cancer center, Department of Radiology, College of Medicine, The Catholic University or Korea)
Cho, Deog Gon (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Cho, Kyu Do (Lung Cancer center, Department of Thoracic Surgery, College of Medicine, The Catholic University or Korea)
Kim, Hoon-Kyo (Lung Cancer center, Department of Internal Medicine, College of Medicine, The Catholic University or Korea)
Publication Information
Tuberculosis and Respiratory Diseases / v.62, no.3, 2007 , pp. 217-222 More about this Journal
Abstract
Talc pleurodesis is a safe and effective treatment for a recurrent malignant pleural effusion. However, acute hypoxemia, pulmonary edema or acute respiratory failure can develop in a small number of patients. We report 2 patients who developed fatal hypoxemia after talc pleurodesis which was necessary the control recurrent pleural effusion. The first case was an 18-year old male diagnosed with Ewing's sarcoma with bilateral lung metastases and pleural effusion. The performance status was ECOG (Eastern Cooperative Foncology Group) grade 3. Fever along with hypoxemia and leukocytosis developed 10 hours after the second talc pleurodesis on the right side for an uncontrolled pleural effusion, The patient died from respiratory failure after 13 days. The second case was a 66-year old female diagnosed with non-small cell lung cancer with a bone metastasis. Two weeks after systemic chemotherapy, she complained of dyspnea, and a pleural effusion was observed on the right side. Her performance status was ECOG grade 3. Talc pleurodesis was performed for recurrent pleural effusion, but hypoxemia developed 6 days after pleurodesis and she died from respiratory failure 10 days after pleurodesis. In conclusion, talc pleurodesis should be performed very carefully in patients with a poor performance status, in cases with repeated pleurodesis, bilateral pleural effusion, recent chemotherapy, radiotherapy and when there are parenchymal metastatic lesions present.
Keywords
Pleural effusion; Talc; Pleurodesis; Hypoxemia;
Citations & Related Records

Times Cited By SCOPUS : 0
연도 인용수 순위
  • Reference
1 Kim KU, Cha KY, Han SH, Yun YI, Park SW, Kim DJ, et al. A case of acute respiratory distress syndrome (ARDS) after talc pleurodesis. Tuberc Respir Dis 2001;51:265-9   DOI
2 Kennedy L, Rusch VW, Strange C, Ginsberg RJ, Sahn SA. Pleurodesis using talc slurry. Chest 1994;106: 342-6   DOI   ScienceOn
3 Marchi E, Teixeira LR, Vargas FS. Management of malignancy- associated pleural effusion: current and future treatment strategies. Am J Respir Med 2003;2:261-73   DOI   ScienceOn
4 Antunes G, Neville E. Management of malignant pleural effusions. Thorax 2000;55:981-3   DOI   ScienceOn
5 Neragi-Miandoab S. Malignant pleural effusion, current and evolving approaches for its diagnosis and management. Lung Cancer 2006;54:1-9   DOI   ScienceOn
6 Bernard A, de Dompsure RB, Hagry O, Favre JP. Early and late mortality after pleurodesis for malignant pleural effusion. Ann Thorac Surg 2002;74:213-7   DOI   ScienceOn
7 Bondoc AY, Bach PB, Sklarin NT, Vander Els NJ. Arterial desaturation syndrome following pleurodesis with talc slurry: incidence, clinical features, and outcome. Cancer Invest 2003;21:848-54   DOI   ScienceOn
8 Rehse DH, Aye RW, Florence MG. Respiratory failure following talc pleurodesis. Am J Surg 1999;177: 437-40   DOI
9 Brega-Massone PP, Lequaglie C, Magnani B, Ferro F, Cataldo I. Chemical pleurodesis to improve patients' quality of life in the management of malignant pleural effusions: the 15 year experience of the National Cancer Institute of Milan. Surg Laparosc Endosc Percutan Tech 2004;14:73-9   DOI
10 Antony VB, Nasreen N, Mohammed KA, Sriram PS, Frank W, Schoenfeld N, et al. Talc pleurodesis: basic fibroblast growth factor mediates pleural fibrosis. Chest 2004;126:1522-8   DOI   ScienceOn
11 Yim AP, Chan AT, Lee TW, Wan IY, Ho JK. Thoracoscopic talc insufflation versus talc slurry for symptomatic malignant pleural effusion. Ann Thorac Surg 1996;62:1655-8   DOI   ScienceOn
12 Viallat JR, Rey F, Astoul P, Boutin C. Thoracoscopic talc poudrage pleurodesis for malignant effusions: a review of 360 cases. Chest 1996;110:1387-93   DOI   ScienceOn
13 Kuzniar TJ, Blum MG, Kasibowska-Kuzniar K, Mutlu GM. Predictors of acute lung injury and severe hypoxemia in patients undergoing operative talc pleurodesis. Ann Thorac Surg 2006;82:1976-81   DOI   ScienceOn
14 Lee YC, Light RW. Management of malignant pleural effusions. Respirology 2004;9:148-56   DOI   ScienceOn