ABSTRACT TITLE

To study the efficacy of time dependant Vs Volume dependant chest drain removal protocol for Talc pleurodesis in patients with malignant pleural effusion.

BACKGROUND

Chemical pleurodesis is an established palliative treatments for malignant pleural effusion(MPE). The standard protocol is to remove the chest drain after the daily fluid drain decreases to less than 150ml/24 hours, which usually takes an average 2 to 6 days. We study if early chest drain removal (within 12 hours) can reduce the duration of hospital stay without increasing the failure rate of pleurodesis or complications.

AIM

To study the efficacy of time dependent (12 hours) Vs volume dependent(<150ml/day) chest drain removal protocol for Talc pleurodesis in patients with MPE.

METHODS

A single centre, double blinded, RCT conducted between July 2020 to July 2022. Patients diagnosed with MPE referred for pleurodesis were randomly assigned into volume dependent arm and time dependent arm for talc pleurodesis.

RESULTS

103 patients were randomized in Time arm (53) or Volume arm (50).Clinical success rate of pleurodesis was not significantly different in Time [86%] vs Volume arm [80%] (p=0.63) at 1 month and Time [75%] vs Volume arm [72%] (p=0.65) at 3 months. Time-based ICD removal protocol saved average 27 hours of each patient time to be free from Chest tube drainage (p=0.018). Mortality or complications were not statistically different in either arm.

CONCLUSION

Time based rapid Talc pleurodesis is equally efficacious with no difference in mortality and complications  compared to standard volume-based protocol for chest drain removal post pleurodesis.