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The following is a summary of “Rapid Pleurodesis in Patients With Chronic Noninfectious Pleural Effusion,” published in the January 2025 issue of Pulmonology by Pu et al. 

Small cohort studies indicated that rapid pleurodesis protocols (RPP) effectively expedited pleurodesis for malignant pleural effusion (MPE).  

Researchers conducted a retrospective study to evaluate the effectiveness of the RPP in inducing pleurodesis for pleural effusions from malignant or benign causes.  

They analyzed individuals with recurrent symptomatic chronic noninfectious pleural effusions, both benign and malignant, over 20 years. Post-RPP, chest tubes were removed when fluid output was below 150 mL per day, and daily drainage using an indwelling pleural catheter (IPC) was prescribed. Individuals with nonexpandable lungs or active pleural infections were excluded. Treatment success was defined as IPC removal following reduced output (<50 mL) over 3 consecutive drainages and radiologic resolution of effusion. Recurrence was noted if pleural effusion required additional procedures post-success. Duration outcomes were expressed as median, with IPC placement as time 0.  

The results showed that among 210 individuals, 72% had MPE, while 28% had benign effusions. The median hospital stay after the RPP was 4 days. Treatment was successful in 177 individuals (84%) within a median of 12 days, with no significant difference between MPE and benign cases. Recurrence occurred in 9 individuals (5%) over a median of 152 days. Complications included hemothorax in 4 individuals (1.9%) and 2 individuals with empyema (1%). The 30-day mortality rate was 9%, and the median survival duration post-procedure was 245 days.  

Investigators concluded that the RPP, combining chemical pleurodesis and IPC, appeared to be a reasonable option for patients experiencing recurrent and symptomatic pleural effusion. 

Source: journals.lww.com/bronchology/abstract/2025/01010/rapid_pleurodesis_in_patients_with_chronic.1.aspx