Title

Management of Malignant Pleural Effusions

Authoring Organizations

American Thoracic Society

Society of Thoracic Radiology

Society of Thoracic Surgeons

Publication Month/Year

October 3, 2018

Last Updated Month/Year

October 4, 2024

Document Type

Guideline

External Publication Status

Published

Country of Publication

US

Document Objectives

This document aims to provide practicing clinicians with the synthesis of latest evidence along with recommendations to improve patient centered outcomes.

Target Patient Population

Patients with a malignant pleural effusion (MPE)

PICO Questions

  1. In Patients with Known or Suspected MPE, Should Thoracic Ultrasound Be Used to Guide Pleural Interventions?

  2. In Patients with Known or Suspected MPE Who Are Asymptomatic, Should Pleural Drainage Be Performed?

  3. Should the Management of Patients with Symptomatic Known or Suspected MPE Be Guided by Large-Volume Thoracentesis and Pleural Manometry?

  4. In Patients with Symptomatic MPE with Known or Suspected Expandable Lung and No Prior Definitive Therapy, Should IPCs or Chemical Pleurodesis Be Used as First-Line Definitive Pleural Intervention for Management of Dyspnea?

  5. In Patients with Symptomatic MPE Undergoing Talc Pleurodesis, Should Talc Poudrage or Talc Slurry Be Used?

  6. In Patients with Symptomatic MPE with Nonexpandable Lung, Failed Pleurodesis, or Loculated Effusion, Should an IPC or Chemical Pleurodesis Be Used?

  7. In Patients with IPC-associated Infection (Cellulitis, Tunnel Infection, or Pleural Infection), Should Medical Therapy Alone or Medical Therapy and Catheter Removal Be Used?

Inclusion Criteria

Male, Female, Adult, Older adult

Health Care Settings

Ambulatory, Hospital, Operating and recovery room

Intended Users

Nurse, nurse practitioner, physician, physician assistant, respiratory therapist

Scope

Diagnosis, Assessment and screening, Management

Diseases/Conditions (MeSH)

D010996 - Pleural Effusion, D016066 - Pleural Effusion, Malignant

Keywords

malignant pleural effusion, MPE

Supplemental Methodology Resources

Data Supplement