Randomized Trial of Pleural Fluid Drainage Frequency in Patients with Malignant Pleural Effusions. The ASAP Trial
2017
Rationale: Patients with
malignant pleural effusionshave significant dyspnea and shortened life expectancy. Indwelling pleural catheters allow patients to drain pleural fluid at home and can lead to autopleurodesis. The optimal
drainagefrequency to achieve autopleurodesis and freedom from catheter has not been determined.Objectives: To determine whether an aggressive daily
drainagestrategy is superior to the current standard every other day
drainageof pleural fluid in achieving autopleurodesis.Methods: Patients were randomized to either an aggressive
drainage(daily
drainage; n = 73) or standard
drainage(every other day
drainage; n = 76) of pleural fluid via a tunneled pleural catheter.Measurements and Main Results: The primary outcome was the incidence of autopleurodesis following the placement of the indwelling pleural catheters. The rate of autopleurodesis, defined as complete or partial response based on symptomatic and radiographic changes, was greater in the aggressive
drainagearm than the sta...
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