Key Points
➤ Malignant pleural effusions (MPEs) are the second leading cause
(next to parapneumonic effusions) of exudative effusions, accounting
for greater than 125,000 hospital admissions per year in the United
States and estimated inpatient charges of greater than $5 billion per
year.
➤ Though some patients are initially asymptomatic, the majority will
eventually develop dyspnea at rest.
➤ Likewise, since MPE is associated with an average survival of 4–7
months, treatment should aim to relieve dyspnea in a minimally
invasive manner, and ideally minimize repeated procedures and
interaction with the healthcare system (i.e., to provide a definitive
pleural intervention).
➤ With increasing focus on patient-centered outcomes, many of these
techniques, including thoracoscopy and placement of indwelling
pleural catheters (IPCs), can be performed in the outpatient setting.