Complications after Indwelling Pleural Catheter Implant for Symptomatic Recurrent Benign and Malignant Pleural Effusions

Background Implant of indwelling pleural catheters (IPC) represents an established therapy method in addition to pleurodesis for symptomatic recurrent benign and malignant pleural effusions (BPE and MPE). There are only few studies on IPC safety during follow-up, especially with regard to infection and pneumothorax rates. The aim of our investigation was to determine the complication frequency after IPC implant and its predictive factors in patients with BPE vs. MPE. Methods Retrospective analysis of all IPC implantations in the pneumology department at the University Hospital Dresden during 2015-2018. Results An IPC was implanted in 86 patients (43m/f each; age 66.9 +/- 13.3 years) with symptomatic BPE and MPE. BPE and MPE was present in 12.8% (11/86) and 87.2% (75/86) of the patients, respectively. A predominantly small and asymptomatic pneumothorax was detectable as an immediate complication in 43/86 (50%) of patients; 34/43 (79%) of patients did not require any specific therapy. For 9/43 patients, IPC suction was required for a median period of three days; 8/43 patients had a large pneumothorax with partial or complete regression after a median period of two days. Catheter infection developed in 15.1% (13/86) of the total group and 36.4% (4/11) of the BPE vs. 12% (9/75) of the MPE after a median period of 87 (BPE/MPE 116/87) days. This was more common in BPE (p=0.035), large pneumothorax (4/8 patients; p=0.015) and longer catheter dwell times (124 +/- 112 vs. 71 +/- 112 days; p=0.07). Conclusion Small pneumothoraxes are frequent after IPC implantation, but usually do not require specific therapy. IPC infection was detected in 15.1% of all patients after a median period of 87 days. This was more common in patients with BPE, longer catheter dwell times and large pneumothorax.