Arterial desaturation syndrome following pleurodesis with talc slurry: Incidence, clinical features, and outcome Journal Article

Authors: Bondoc, A. Y.; Bach, P. B.; Sklarin, N. T.; Vander Els, N. J.
Article Title: Arterial desaturation syndrome following pleurodesis with talc slurry: Incidence, clinical features, and outcome
Abstract: The objectives were to define the incidence, risk factors, clinical features and outcome of arterial desaturation syndrome following talc pleurodesis in patients with malignant pleural effusions. This retrospective, observational study took place at a tertiary care cancer center in New York. All patients were those with malignancy who underwent pleurodesis with talc in 1998 at Memorial Sloan Kettering Cancer Center. Characteristics of patients are described by using summary statistics. Differences between groups were assessed with the Fisher's exact statistic for categorical variables and Student's t-test for continuous variables. Among patients who were considered to have arterial desaturation syndrome, we evaluated the relation of SaO2/FIO2 pre- and post-talc installation using a paired Student's t-test. During 1998, 120 patients underwent pleurodesis with talc, and 8 (7%) developed arterial desaturation following the procedure. Symptoms included chest pain, dyspnea, fever, and increased need for oxygen supplementation developed typically within 1 day. Three of the eight patients in this series required mechanical ventilation, but all recovered uneventfully after treatment, which included high-dose corticosteroids. Patients with breast and ovarian cancer appeared to be at increased risk for this complication compared to those patients with other types of cancer (p=0.01). Approximately 7% of patients who have undergone sclerosis with talc for a malignant pleural effusion will develop arterial desaturation with clinically significant hypoxia requiring supplemental oxygen following the procedure. It appears that most patients recover from this complication and that those with breast and ovarian cancer may be at higher risk.
Keywords: adult; clinical article; controlled study; treatment outcome; middle aged; retrospective studies; clinical feature; drug megadose; ovarian neoplasms; ovary cancer; breast cancer; incidence; risk factors; retrospective study; risk factor; high risk patient; dyspnea; fever; thorax pain; syndrome; pleura effusion; symptomatology; corticosteroid; convalescence; oxygen supply; artificial ventilation; respiratory failure; pleurodesis; arteries; pleural effusion; adrenal cortex hormones; talc pleurodesis; oxygen inhalation therapy; talc; respiratory distress syndrome, adult; malignant pleural effusions; humans; prognosis; human; male; female; priority journal; article; ards after talc pleurodesis; arterial desaturation syndrome
Journal Title: Cancer Investigation
Volume: 21
Issue: 6
ISSN: 0735-7907
Publisher: Informa Healthcare  
Date Published: 2003-01-01
Start Page: 848
End Page: 854
Language: English
DOI: 10.1081/cnv-120025087
PUBMED: 14735688
PROVIDER: scopus
Notes: Export Date: 12 September 2014 -- Source: Scopus
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MSK Authors
  1. Nancy T Sklarin
    46 Sklarin
  2. Anna York Bondoc
    3 Bondoc
  3. Peter Bach
    200 Bach