The Impact of a Gravity Versus Vacuum Based Indwelling Tunneled Pleural Drainage System on Pain: A Multicenter, Randomized Trial
Malignant pleural effusion remains a debilitating complication of end stage cancer, which can be greatly improved by the introduction of the indwelling tunneled pleural catheter (IPC). However, there is no standard of care regarding drainage and limited data on the utility of different drainage techniques. In addition, many patients develop discomfort and chest pain during drainage. The investigators propose to evaluate gravity drainage and suction drainage on quality of life measures and outcomes.
• Clinical indications for placement of IPC for malignant pleural effusion
• a. Pleural effusion with symptomatic improvement in dyspnea after drainage of ipsilateral effusion
• Clinically confident symptomatic malignant pleural effusion
‣ Histocytological proof of pleural malignancy
⁃ Recurrent large pleural effusion in context of histologically proven cancer outside the pleural space
• Plans for placement of IPC within ten days of enrollment
• Age \> 17 years
• Sufficient fluid on ultrasound to allow for safe insertion of IPC