AABIP Evidence-informed Guidelines and Expert Panel Report for the Management of Indwelling Pleural Catheters.


Journal

Journal of bronchology & interventional pulmonology
ISSN: 1948-8270
Titre abrégé: J Bronchology Interv Pulmonol
Pays: United States
ID NLM: 101496866

Informations de publication

Date de publication:
Oct 2020
Historique:
pubmed: 18 8 2020
medline: 9 7 2021
entrez: 18 8 2020
Statut: ppublish

Résumé

While the efficacy of Indwelling pleural catheters for palliation of malignant pleural effusions is supported by relatively robust evidence, there is less clarity surrounding the postinsertion management. The Trustworthy Consensus-Based Statement approach was utilized to develop unbiased, scientifically valid guidance for the management of patients with malignant effusions treated with indwelling pleural catheters. A comprehensive electronic database search of PubMed was performed based on a priori crafted PICO questions (Population/Intervention/Comparator/Outcomes paradigm). Manual searches of the literature were performed to identify additional relevant literature. Dual screenings at the title, abstract, and full-text levels were performed. Identified studies were then assessed for quality based on a combination of validated tools. Appropriateness for data pooling and formation of evidence-based recommendations was assessed using predetermined criteria. All panel members participated in development of the final recommendations utilizing the modified Delphi technique. A total of 7 studies were identified for formal quality assessment, all of which were deemed to have a high risk of bias. There was insufficient evidence to allow for data pooling and formation of any evidence-based recommendations. Panel consensus resulted in 11 ungraded consensus-based recommendations. This manuscript was developed to provide clinicians with guidance on the management of patients with indwelling pleural catheters placed for palliation of malignant pleural effusions. Through a systematic and rigorous process, management suggestions were developed based on the best available evidence with augmentation by expert opinion when necessary. In addition, these guidelines highlight important gaps in knowledge which require further study.

Sections du résumé

BACKGROUND BACKGROUND
While the efficacy of Indwelling pleural catheters for palliation of malignant pleural effusions is supported by relatively robust evidence, there is less clarity surrounding the postinsertion management.
METHODS METHODS
The Trustworthy Consensus-Based Statement approach was utilized to develop unbiased, scientifically valid guidance for the management of patients with malignant effusions treated with indwelling pleural catheters. A comprehensive electronic database search of PubMed was performed based on a priori crafted PICO questions (Population/Intervention/Comparator/Outcomes paradigm). Manual searches of the literature were performed to identify additional relevant literature. Dual screenings at the title, abstract, and full-text levels were performed. Identified studies were then assessed for quality based on a combination of validated tools. Appropriateness for data pooling and formation of evidence-based recommendations was assessed using predetermined criteria. All panel members participated in development of the final recommendations utilizing the modified Delphi technique.
RESULTS RESULTS
A total of 7 studies were identified for formal quality assessment, all of which were deemed to have a high risk of bias. There was insufficient evidence to allow for data pooling and formation of any evidence-based recommendations. Panel consensus resulted in 11 ungraded consensus-based recommendations.
CONCLUSION CONCLUSIONS
This manuscript was developed to provide clinicians with guidance on the management of patients with indwelling pleural catheters placed for palliation of malignant pleural effusions. Through a systematic and rigorous process, management suggestions were developed based on the best available evidence with augmentation by expert opinion when necessary. In addition, these guidelines highlight important gaps in knowledge which require further study.

Identifiants

pubmed: 32804745
doi: 10.1097/LBR.0000000000000707
pii: 01436970-202010000-00004
doi:

Types de publication

Journal Article Meta-Analysis Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

229-245

Subventions

Organisme : Marie Curie
ID : MCCC-RP-14-A17178
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn

Références

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Auteurs

Russell J Miller (RJ)

Department of Pulmonary Medicine, Naval Medical Center San Diego.
Department of Medicine, University of California San Diego, San Diego.

Ara A Chrissian (AA)

Department of Medicine, Division of Pulmonary and Critical Care, Loma Linda University Medical Center, Loma Linda.

Y C Gary Lee (YCG)

Centre for Respiratory Research, School of Medicine.
Institute for Respiratory Health, University of Western Australia.
Department of Respiratory Medicine, Sir Charles Gairdner Hospital.
Edith Cowan University, Perth, WA, Australia.

Najib M Rahman (NM)

Oxford Respiratory Trials Unit, Nuffield Department of Experimental Medicine, University of Oxford, Oxford, UK.

Momen M Wahidi (MM)

Department of Internal Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Duke University Medical Center, Durham.

Alain Tremblay (A)

Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

David W Hsia (DW)

Harbor-University of California Los Angeles Medical Center.
Los Angeles Biomedical Research Institute at Harbor-University of California Los Angeles, Torrance.

Francisco A Almeida (FA)

Respiratory Institute, Cleveland Clinic Foundation, Cleveland, OH.

Samira Shojaee (S)

Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Virginia Commonwealth University, Richmond, VA.

Lakshmi Mudambi (L)

Section of Pulmonary & Critical Care Medicine, VA Portland Health Care System.
Department of Medicine, Division of Pulmonary & Critical Care Medicine, Oregon Health & Science University, Portland, OR.

Adam R Belanger (AR)

Section of Interventional Pulmonology, Department of Medicine, University of North Carolina, Chapel Hill, NC.

Harmeet Bedi (H)

Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford.

Yaron B Gesthalter (YB)

Department of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California San Francisco, San Francisco, CA.

Margaret Gaynor (M)

Chicago Chest Center, Chicago.

Karen L MacKenney (KL)

Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.

Sandra Z Lewis (SZ)

EBQ Consulting LLC, Northbrook, IL.

Roberto F Casal (RF)

Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.

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