pleurodesis; chemical pleurodesis

Indications

• recurrent pneumothorax
• recurrent pleural effusion

Procedure

• pleural instillation of sclerosing agent (sclerotherapy) through a chest tube
• sclerosing agent mixed in 30 mL of saline
  • tetracycline (15 mg/kg)
  • doxycycline (10 mg/kg)
  • minocycline (5 mg/kg)
  • bleomycin
  • talc (2.5-10 g) - 90% effective
• surgical pleurodesis may be effective in closing pleural space when chemical agents fail

Management

• NSAIDs vs opiates results in no significant difference in pain scores but is associated with more rescue medication
• placement of smaller 12F chest tubes vs 24F chest tubes is associated with a statistically significant but clinically modest reduction in pain but fails to meet noninferiority criteria for pleurodesis efficacy

More general terms

• cardiothoracic surgery
• sclerotherapy (phlebosclerosis)

More specific terms

• thorascopy with pleurodesis

Additional terms

• pleural effusion
• pneumothorax