Management of Indwelling Tunneled Pleural Catheters: A Modified Delphi Consensus Statement

Interventional Pulmonary Outcomes Group

doi:10.1016/j.chest.2020.05.594

Management of Indwelling Tunneled Pleural Catheters: A Modified Delphi Consensus Statement

Interventional Pulmonary Outcomes Group

Pulmonary Medicine

Research output: Contribution to journal › Article › peer-review

25 Scopus citations

Abstract

Background: The management of recurrent pleural effusions remains a challenging issue for clinicians. Advances in management have led to increased use of indwelling tunneled pleural catheters (IPC) because of their effectiveness and ease of outpatient placement. However, with the increase in IPC placement there have also been increasing reports of complications, including infections. Currently there is minimal guidance in IPC-related management issues after placement. Research Question: Our objective was to formulate clinical consensus statements related to perioperative and long-term IPC catheter management based on a modified Delphi process from experts in pleural disease management. Study Design and Methods: Expert panel members used a modified Delphi process to reach consensus on common perioperative and long-term management options related to IPC use. Members were identified from multiple countries, specialties, and practice settings. A series of meetings and anonymous online surveys were completed. Responses were used to formulate consensus statements among panel experts, using a modified Delphi process. Consensus was defined a priori as greater than 80% agreement among panel constituents. Results: A total of 25 physicians participated in this project. The following topics were addressed during the process: definition of an IPC infection, management of IPC-related infectious complications, interventions to prevent IPC infections, IPC-related obstruction/malfunction management, assessment of IPC removal, and instructions regarding IPC management by patients and caregivers. Strong consensus was obtained on 36 statements. No consensus was obtained on 29 statements. Interpretation: The management of recurrent pleural disease with IPC remains complex and challenging. This statement offers statements for care in numerous areas related to IPC management based on expert consensus and identifies areas that lack consensus. Further studies related to long-term management of IPC are warranted.

Original language	English (US)
Pages (from-to)	2221-2228
Number of pages	8
Journal	Chest
Volume	158
Issue number	5
DOIs	https://doi.org/10.1016/j.chest.2020.05.594
State	Published - Nov 2020

Keywords

indwelling tunneled pleural catheter
malignant pleural effusion
pleural catheter infection
pleural catheter management
pleurodesis

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Critical Care and Intensive Care Medicine
Cardiology and Cardiovascular Medicine

Access to Document

10.1016/j.chest.2020.05.594

Cite this

@article{a0fc729442cb4fa5a22db84dda138164,

title = "Management of Indwelling Tunneled Pleural Catheters: A Modified Delphi Consensus Statement",

abstract = "Background: The management of recurrent pleural effusions remains a challenging issue for clinicians. Advances in management have led to increased use of indwelling tunneled pleural catheters (IPC) because of their effectiveness and ease of outpatient placement. However, with the increase in IPC placement there have also been increasing reports of complications, including infections. Currently there is minimal guidance in IPC-related management issues after placement. Research Question: Our objective was to formulate clinical consensus statements related to perioperative and long-term IPC catheter management based on a modified Delphi process from experts in pleural disease management. Study Design and Methods: Expert panel members used a modified Delphi process to reach consensus on common perioperative and long-term management options related to IPC use. Members were identified from multiple countries, specialties, and practice settings. A series of meetings and anonymous online surveys were completed. Responses were used to formulate consensus statements among panel experts, using a modified Delphi process. Consensus was defined a priori as greater than 80% agreement among panel constituents. Results: A total of 25 physicians participated in this project. The following topics were addressed during the process: definition of an IPC infection, management of IPC-related infectious complications, interventions to prevent IPC infections, IPC-related obstruction/malfunction management, assessment of IPC removal, and instructions regarding IPC management by patients and caregivers. Strong consensus was obtained on 36 statements. No consensus was obtained on 29 statements. Interpretation: The management of recurrent pleural disease with IPC remains complex and challenging. This statement offers statements for care in numerous areas related to IPC management based on expert consensus and identifies areas that lack consensus. Further studies related to long-term management of IPC are warranted.",

keywords = "indwelling tunneled pleural catheter, malignant pleural effusion, pleural catheter infection, pleural catheter management, pleurodesis",

author = "{Interventional Pulmonary Outcomes Group} and Gilbert, {Christopher R.} and Wahidi, {Momen M.} and Light, {Richard W.} and Rivera, {M. Patricia} and Sterman, {Daniel H.} and Rajesh Thomas and Samira Shojaee and Shmuel Shoham and Ioannis Psallidas and Ost, {David E.} and Daniela Molena and Nick Maskell and Fabien Maldonado and Moishe Liberman and Lee, {Y. C.Gary} and Hans Lee and Herth, {Felix J.F.} and Horiana Grosu and Gorden, {Jed A.} and Fysh, {Edward T.H.} and Corcoran, {John P.} and Argento, {A. Christine} and Akulian, {Jason A.} and Rahman, {Najib M.} and Yarmus, {Lonny B.}",

note = "Publisher Copyright: {\textcopyright} 2020 American College of Chest Physicians",

year = "2020",

month = nov,

doi = "10.1016/j.chest.2020.05.594",

language = "English (US)",

volume = "158",

pages = "2221--2228",

journal = "Chest",

issn = "0012-3692",

publisher = "American College of Chest Physicians",

number = "5",

}

TY - JOUR

T1 - Management of Indwelling Tunneled Pleural Catheters

T2 - A Modified Delphi Consensus Statement

AU - Interventional Pulmonary Outcomes Group

AU - Gilbert, Christopher R.

AU - Wahidi, Momen M.

AU - Light, Richard W.

AU - Rivera, M. Patricia

AU - Sterman, Daniel H.

AU - Thomas, Rajesh

AU - Shojaee, Samira

AU - Shoham, Shmuel

AU - Psallidas, Ioannis

AU - Ost, David E.

AU - Molena, Daniela

AU - Maskell, Nick

AU - Maldonado, Fabien

AU - Liberman, Moishe

AU - Lee, Y. C.Gary

AU - Lee, Hans

AU - Herth, Felix J.F.

AU - Grosu, Horiana

AU - Gorden, Jed A.

AU - Fysh, Edward T.H.

AU - Corcoran, John P.

AU - Argento, A. Christine

AU - Akulian, Jason A.

AU - Rahman, Najib M.

AU - Yarmus, Lonny B.

PY - 2020/11

Y1 - 2020/11

N2 - Background: The management of recurrent pleural effusions remains a challenging issue for clinicians. Advances in management have led to increased use of indwelling tunneled pleural catheters (IPC) because of their effectiveness and ease of outpatient placement. However, with the increase in IPC placement there have also been increasing reports of complications, including infections. Currently there is minimal guidance in IPC-related management issues after placement. Research Question: Our objective was to formulate clinical consensus statements related to perioperative and long-term IPC catheter management based on a modified Delphi process from experts in pleural disease management. Study Design and Methods: Expert panel members used a modified Delphi process to reach consensus on common perioperative and long-term management options related to IPC use. Members were identified from multiple countries, specialties, and practice settings. A series of meetings and anonymous online surveys were completed. Responses were used to formulate consensus statements among panel experts, using a modified Delphi process. Consensus was defined a priori as greater than 80% agreement among panel constituents. Results: A total of 25 physicians participated in this project. The following topics were addressed during the process: definition of an IPC infection, management of IPC-related infectious complications, interventions to prevent IPC infections, IPC-related obstruction/malfunction management, assessment of IPC removal, and instructions regarding IPC management by patients and caregivers. Strong consensus was obtained on 36 statements. No consensus was obtained on 29 statements. Interpretation: The management of recurrent pleural disease with IPC remains complex and challenging. This statement offers statements for care in numerous areas related to IPC management based on expert consensus and identifies areas that lack consensus. Further studies related to long-term management of IPC are warranted.

AB - Background: The management of recurrent pleural effusions remains a challenging issue for clinicians. Advances in management have led to increased use of indwelling tunneled pleural catheters (IPC) because of their effectiveness and ease of outpatient placement. However, with the increase in IPC placement there have also been increasing reports of complications, including infections. Currently there is minimal guidance in IPC-related management issues after placement. Research Question: Our objective was to formulate clinical consensus statements related to perioperative and long-term IPC catheter management based on a modified Delphi process from experts in pleural disease management. Study Design and Methods: Expert panel members used a modified Delphi process to reach consensus on common perioperative and long-term management options related to IPC use. Members were identified from multiple countries, specialties, and practice settings. A series of meetings and anonymous online surveys were completed. Responses were used to formulate consensus statements among panel experts, using a modified Delphi process. Consensus was defined a priori as greater than 80% agreement among panel constituents. Results: A total of 25 physicians participated in this project. The following topics were addressed during the process: definition of an IPC infection, management of IPC-related infectious complications, interventions to prevent IPC infections, IPC-related obstruction/malfunction management, assessment of IPC removal, and instructions regarding IPC management by patients and caregivers. Strong consensus was obtained on 36 statements. No consensus was obtained on 29 statements. Interpretation: The management of recurrent pleural disease with IPC remains complex and challenging. This statement offers statements for care in numerous areas related to IPC management based on expert consensus and identifies areas that lack consensus. Further studies related to long-term management of IPC are warranted.

KW - indwelling tunneled pleural catheter

KW - malignant pleural effusion

KW - pleural catheter infection

KW - pleural catheter management

KW - pleurodesis

UR - http://www.scopus.com/inward/record.url?scp=85093952768&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85093952768&partnerID=8YFLogxK

U2 - 10.1016/j.chest.2020.05.594

DO - 10.1016/j.chest.2020.05.594

M3 - Article

C2 - 32561437

AN - SCOPUS:85093952768

SN - 0012-3692

VL - 158

SP - 2221

EP - 2228

JO - Chest

JF - Chest

IS - 5

ER -

Management of Indwelling Tunneled Pleural Catheters: A Modified Delphi Consensus Statement

Abstract

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this