HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Robinson, L. A. Articles by Galbraith, T. A. Search for Related Content PubMed PubMed Citation Articles by Robinson, L. A. Articles by Galbraith, T. A.

The Annals of Thoracic Surgery, Vol 55, 1115-1121, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

Intrapleural doxycycline control of malignant pleural effusions

LA Robinson, WH Fleming and TA Galbraith
Section of Thoracic and Cardiovascular Surgery, University of Nebraska Medical Center, Omaha 68198-2315.

The intrapleural instillation of agents for pleural sclerosis has proved effective in preventing the reaccumulation of symptomatic malignant pleural effusions. Because manufacture of the most popular agent, tetracycline, was recently discontinued, a preliminary study was undertaken to evaluate an alternative agent, doxycycline, for treating symptomatic malignant pleural effusions. From November 1991 to September 1992, 21 patients with symptomatic malignant pleural effusions have undergone overnight chest tube drainage followed by intrapleural instillation of 10 mL 1% lidocaine and then doxycycline, 500 mg in 30 mL 0.9% saline solution. The chest tube was clamped 2 hours with patient repositioning every 15 minutes. Tubes were removed when drainage was less than 50 mL/8 h. Of surviving patients, a complete objective response at 1 month was obtained in 88% (15/17), who were free of a symptomatic or radiographic recurrence of the effusion. Complications included mild pain in 23% (5/21), moderate pain requiring analgesics in 19% (4/21), and mild fever in 5% (1/21). There were no treatment-related deaths. The mean time for chest tube removal was 1.7 +/- 0.7 days after the last treatment. Based on this preliminary study, we conclude that doxycycline is a highly effective agent for the palliative treatment of symptomatic malignant pleural effusions. Its safety profile and efficacy compare favorably with those of tetracycline and other agents used for pleural sclerosis.

This article has been cited by other articles:

				W. H. Warren, R. Kalimi, L. M. Khodadadian, and A. W. Kim Management of Malignant Pleural Effusions Using the Pleurx Catheter Ann. Thorac. Surg., March 1, 2008; 85(3): 1049 - 1055. [Abstract] [Full Text] [PDF]

				W. H. Warren, A. W. Kim, and M. J. Liptay Identification of clinical factors predicting Pleurx (R) catheter removal in patients treated for malignant pleural effusion Eur. J. Cardiothorac. Surg., January 1, 2008; 33(1): 89 - 94. [Abstract] [Full Text] [PDF]

				P. A. Kvale, P. A. Selecky, and U. B. S. Prakash Palliative Care in Lung Cancer: ACCP Evidence-Based Clinical Practice Guidelines (2nd Edition) Chest, September 1, 2007; 132(3_suppl): 368S - 403S. [Abstract] [Full Text] [PDF]

				S. G. Tejwani, S. B. Cohen, and J. P. Bradley Management of Morel-Lavallee Lesion of the Knee: Twenty-Seven Cases in the National Football League Am. J. Sports Med., July 1, 2007; 35(7): 1162 - 1167. [Abstract] [Full Text] [PDF]

				G Antunes, E Neville, J Duffy, and N Ali BTS guidelines for the management of malignant pleural effusions Thorax, May 1, 2003; 58(90002): ii29 - 38. [Full Text]

				E. M. Marom, J. J. Erasmus, J. E. Herndon II, C. Zhang, and H. P. McAdams Usefulness of Imaging-Guided Catheter Drainage and Talc Sclerotherapy in Patients with Metastatic Gynecologic Malignancies and Symptomatic Pleural Effusions Am. J. Roentgenol., July 1, 2002; 179(1): 105 - 108. [Abstract] [Full Text] [PDF]

				J. B. Putnam Jr, G. L. Walsh, S. G. Swisher, J. A. Roth, D. M. Suell, A. A. Vaporciyan, W. R. Smythe, K. W. Merriman, and L. L. DeFord Outpatient management of malignant pleural effusion by a chronic indwelling pleural catheter Ann. Thorac. Surg., February 1, 2000; 69(2): 369 - 375. [Abstract] [Full Text] [PDF]

				E. M. Marom, E. F. Patz Jr, J. J. Erasmus, H. P. McAdams, P. C. Goodman, and J. E. Herndon Malignant Pleural Effusions: Treatment with Small-Bore-Catheter Thoracostomy and Talc Pleurodesis Radiology, January 1, 1999; 210(1): 277 - 281. [Abstract] [Full Text]