Indwelling Pleural Catheters an Option for Hepatic Hydrothorax Treatment

Indwelling pleural catheters can treat eligible patients with refractory hepatic hydrothorax, according to a recent study published in CHEST.

This retrospective study examined patients who received an indwelling pleural catheter for the treatment of cirrhosis or hepatic hydrothorax. Laboratory results and body mass index were measured at placement, and follow-up data included complications and catheter malfunctions. The reason for the catheter was also categorized, either as a bridge to transplant (n=33), palliative (n=24), or unclear (n=5).

Complication rates were high, with 36% of the patients having some type of complication, and empyema was the most common complication (16.1%). A liver transplant was successful in 10 patients, and the indwelling pleural catheter was removed in all but 1 patient who received a transplant. 

Body mass index was reduced by 1.13 kg/m² (P =.008), and serum albumin was reduced by 0.3 g/dL (P =.005). These were statistically significant reductions in protein and electrolytes, but they lacked clinical significance. Further research is needed to identify the population that would best benefit from an indwelling pleural catheter.

In conclusion, indwelling pleural catheters can be used safely but with caution in eligible patients as a bridge to transplant and palliative care.

Disclosures: This study was supported by the Indiana Clinical and Translational Sciences Institute and the National Institutes of Health.

Reference

Kniese C, Diab K, Ghabril M, Bosslet G. Indwelling pleural catheters in hepatic hydrothorax: a single-center series of outcomes and complications [published online July 7, 2018]. CHEST. doi:10.1016/j.chest.2018.07.001