Introduction: Talc is currently the most common agent used for pleurodesis. Despite its role acknowledged as an effective bed side strategy primarily in neoplastic pleural effusion, recently it has been introduced in the treatment of benign diseases such as spontaneous pneumothorax. Aim of this study is to investigate side effects and results of different concentrations of talc pleurod- esis (TP) in rabbits. Materials and Methods: Twenty-six New Zealand rabbits were randomly injected intrapleurally with saline (n=6) or talc slurry at usual dosage 40mg/kg (T40, n=10) and 200mg/kg (T200, n=10). Chest tube was opened at day1 post-operative and removed in day4. Clinical signs and symptoms, fluid lactate dehydrogenase and protein levels were measured daily after the injection until drainage removal, then on day7 and before sacrifice. All groups were equally divided in two endpoints: day14 and day28. At post- mortem examination, pleurodesis was graded, according to Light criteria, from 1(none) to 8(>50% symphysis), by two observers blinded to treatment groups. Results: Adverse reactions were discovered with fever and weight loss in T200 group at 14 and 28 days. Pleurodesis score in the control Saline was negative while it did not differ significantly between T200 (4.0±1.4 at 14 days, 4.2±1.6 at 28 days) and T40 (2.8±2.0 at 14 days, 3.6±1.9 at 28 days) at days 14 and 28 (p=0.25 and p=0.56 respectively). Microscopically several granulomas, moderate localized pleural thickness, few areas of neoangiogen- esis and mediastinal lymphathic tissue infiltration were present in both study groups. Conclusions: TP at usual clinical dosage is well tolerated with acceptable clinical results. By increasing the concentration we observed severe side-effects with only mild improvement of pleurodesis.
Update on Talc Pleurodesis. What’s New?
DADDI, NICCOLO';Tassi V;
2009
Abstract
Introduction: Talc is currently the most common agent used for pleurodesis. Despite its role acknowledged as an effective bed side strategy primarily in neoplastic pleural effusion, recently it has been introduced in the treatment of benign diseases such as spontaneous pneumothorax. Aim of this study is to investigate side effects and results of different concentrations of talc pleurod- esis (TP) in rabbits. Materials and Methods: Twenty-six New Zealand rabbits were randomly injected intrapleurally with saline (n=6) or talc slurry at usual dosage 40mg/kg (T40, n=10) and 200mg/kg (T200, n=10). Chest tube was opened at day1 post-operative and removed in day4. Clinical signs and symptoms, fluid lactate dehydrogenase and protein levels were measured daily after the injection until drainage removal, then on day7 and before sacrifice. All groups were equally divided in two endpoints: day14 and day28. At post- mortem examination, pleurodesis was graded, according to Light criteria, from 1(none) to 8(>50% symphysis), by two observers blinded to treatment groups. Results: Adverse reactions were discovered with fever and weight loss in T200 group at 14 and 28 days. Pleurodesis score in the control Saline was negative while it did not differ significantly between T200 (4.0±1.4 at 14 days, 4.2±1.6 at 28 days) and T40 (2.8±2.0 at 14 days, 3.6±1.9 at 28 days) at days 14 and 28 (p=0.25 and p=0.56 respectively). Microscopically several granulomas, moderate localized pleural thickness, few areas of neoangiogen- esis and mediastinal lymphathic tissue infiltration were present in both study groups. Conclusions: TP at usual clinical dosage is well tolerated with acceptable clinical results. By increasing the concentration we observed severe side-effects with only mild improvement of pleurodesis.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
