Using thoracic ultrasound to predict pleurodesis success in MPE
Research type
Research Study
Full title
Using thoracic ultrasound to predict pleurodesis success in malignant pleural effusions: a pilot study
IRAS ID
172087
Contact name
Shahista Hussain
Contact email
Sponsor organisation
Oxford University Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 6 months, 6 days
Research summary
Malignant pleural effusion (MPE) is a common problem which incurs a significant burden on patients. For patients with recurrent MPE, usual care involves drainage via intercostal chest drain (ICD) and talc slurry pleurodesis to adhere the lung to the chest wall and prevent re-accumulation of fluid. This process requires a hospital stay of 5-7 days, with limited information to guide clinicians as to when pleurodesis has succeeded and patients can be discharged home. Furthermore, there is limited evidence addressing the timecourse of pleural adhesion formation following administration of intrapleural talc, nor the optimal timing of ICD removal following talc instillation.
The role of thoracic ultrasound (TUS) in managing pleural disease has expanded over the past decade due to diagnostic and safety benefits. TUS is increasingly used at the bedside by physicians, and there is evidence from animal and human studies to suggest it can identify the presence of pleural adhesions in a variety of conditions. Applying these principles to normal clinical care, there is the potential for TUS to be useful in confirming the formation of pleural adhesions following talc slurry instillation for pleurodesis in MPE - if proven this could allow earlier removal of ICDs, shorten hospital length of stay, reduce costs and identify patients who require further intervention.
This observational pilot study at the Churchill Hospital, Oxford funded by the Oxford Respiratory Trials Unit will assess the feasibility and efficacy of TUS assessment in patients undergoing talc pleurodesis via ICD for recurrent symptomatic MPE. Participants will undergo TUS pre- and post-pleurodesis on up to four occasions. We hypothesise that a TUS scoring system will be able to predict short and long-term pleurodesis success earlier than current conventional medical practice allows. The study may ultimately allow the proposal of a treatment algorithm to manage patients with MPE in a more efficient manner.
REC name
London - Brent Research Ethics Committee
REC reference
15/LO/0382
Date of REC Opinion
26 Feb 2015
REC opinion
Favourable Opinion