Indwelling pleural catheters for benign pleural effusions

Indwelling pleural catheters (IPCs) have an established role in the management of recurrent pleural effusions due to malignancy. They are typically used in patients with trapped lung, those who have previously failed an attempted talc pleurodesis, or as first-line therapy. Experience of, and evidence for, IPC use in this setting is well established. In contrast, IPC use in patients with recurrent pleural effusions due to benign disease is limited, and there are no randomized studies evaluating their efficacy and safety in this patient group. Retrospective data suggest that IPCs may be effective at reducing breathlessness with acceptable complication rates, comparable to those seen in malignant effusions. This paper summarizes the epidemiology, pathophysiology and treatment options for benign pleural effusions, and reviews the published data assessing IPC use in this population.