P138 Indwelling pleural catheter-rare complication: a survey of practice in UK

Résumé fourni par la source

Indwelling pleural catheters (IPC) has made a huge impact in the management of patients with malignant pleural effusion, aiding in both drainage and pleurodesis. Complications of IPC’s are encountered with their increasing usage and include infection, blockage, pain, loculation, tract seedling, displacement. Fracture and severing are encountered during removal and are rare. We aim to see how the pleural team within UK are faced with this rare complication including their management. We were also interested to see if the complication was related to a particular make (Pleurx/Rocket). Methods A nine questions survey (attached figure 1) was generated using Google forms and was sent to all members and non-members of UK pleural society. Results 57 responses were received. 46% mentioned IPC are removed by expert operators only, 36% reported removal was performed by trainees and pleural nurses under supervision. 53% of the responders used Rocket, 25% used Pleurx and 22% used a combination. 40% of the responders have seen IPC fracture, of this 49% will remove using blunt dissection, 38% will do nothing and 13% will/have referred to surgeons. 27% of responders encountered IPC being completely severed, of this 64% reported that they observe and do nothing, 33% will refer to the surgeons for removal and 3% will remove using thoracoscopy. When asked about the outcome of a retained IPC? 62% reported none, 20% mentioned infection. IPC fracture was seen in 38% of the Rocket, 42% of pleurx only users Conclusion 40% of the responders have seen IPC fracture and 27% of the responders have seen IPC completely severed. It’s interesting to see, 33% will refer to the surgeons to remove a severed IPC when the literature supports leaving it alone. Literature evidence and case series show IPC fracture is common with Rocket brand, but the survey suggest the opposite. Further studies are required into the mechanism of fracture and prevention. It is important, a standardised approach is required to manage this rare complication.

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