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Audit on bedside chemical pleurodesis in a palliative care setting: Brunei experience
Affiliations- RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
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Abstract
Background: Malignant pleural effusion typically is a sign of aggressive and advanced disease with generally short life expectancy. This causes a lot of burdens symptomatically to patients with advanced malignancy. Hence, a lot of patients are made known early to palliative service to help optimise patients’ symptomology. One of the procedures to help prevent the recurrence of symptomatic malignant pleural effusion is bedside chemical pleurodesis following thoracocentesis. This audit aims to assess the efficacy and safety of doing the above procedure in a palliative setting.
Patients and methods: Retrospective electronic records of patients were reviewed from January 2020 until March 2022. Malignant pleural effusion was confirmed by cytological assessment of pleural fluid following chest tube drainage. Chemical pleurodesis was done by pleural fluid instillation of bleomycin, performed bedside by palliative physicians.
Results: Twenty patients were identified out of which 7 were male and 13 were female. The mean age was 69.2 with 55% of them suffering from lung malignancy. Complete response is seen in 45% and partial response is seen in 20%. The failure rate is at 35%. The complications were minimal with only 5% of patients having fever and 10% having pleuritic pain.
Conclusions: The audit shows bedside chemical pleurodesis performed by palliative physicians is as efficacious and safe compared to when it is done by other specialities. It helps improve symptoms in 65% of patients and thus improves the quality of life.
Abstract
Background: Malignant pleural effusion typically is a sign of aggressive and advanced disease with generally short life expectancy. This causes a lot of burdens symptomatically to patients with advanced malignancy. Hence, a lot of patients are made known early to palliative service to help optimise patients’ symptomology. One of the procedures to help prevent the recurrence of symptomatic malignant pleural effusion is bedside chemical pleurodesis following thoracocentesis. This audit aims to assess the efficacy and safety of doing the above procedure in a palliative setting.
Patients and methods: Retrospective electronic records of patients were reviewed from January 2020 until March 2022. Malignant pleural effusion was confirmed by cytological assessment of pleural fluid following chest tube drainage. Chemical pleurodesis was done by pleural fluid instillation of bleomycin, performed bedside by palliative physicians.
Results: Twenty patients were identified out of which 7 were male and 13 were female. The mean age was 69.2 with 55% of them suffering from lung malignancy. Complete response is seen in 45% and partial response is seen in 20%. The failure rate is at 35%. The complications were minimal with only 5% of patients having fever and 10% having pleuritic pain.
Conclusions: The audit shows bedside chemical pleurodesis performed by palliative physicians is as efficacious and safe compared to when it is done by other specialities. It helps improve symptoms in 65% of patients and thus improves the quality of life.
Keywords
malignant pleural effusion, pleurodesis, palliative care
About this articleTitle
Audit on bedside chemical pleurodesis in a palliative care setting: Brunei experience
Journal
Palliative Medicine in Practice
Issue
Article type
Research paper
Pages
84-88
Published online
2023-01-16
Page views
1299
Article views/downloads
225
DOI
Bibliographic record
Palliat Med Pract 2023;17(2):84-88.
Keywords
malignant pleural effusion
pleurodesis
palliative care
Authors
Muhammad Yusuf Shaharudin
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