Pleurodesis is a procedure that involves the administration of an agent into the pleural space to cause adhesion to the chest wall (usually from adhesion between the parietal and the visceral layers of the pleura). Usually an irritative chemical agent (chemical pleurodesis) and rarely microbiological and mechanical methods are used.
Indication
It can be used in a number of situation including:
- development of chronic/recurrent pneumothoraces
- development of chronic/recurrent pleural effusions
Agents
Various agents have been used which include:
- talc - talc pleurodesis
- one of the most commonly used
- usually around 2.5-10 mg
- general anesthesia required if instilled by powder; anecdotal reports of pneumonitis and acute respiratory distress syndrome (ARDS)
- tetracycline class antibiotics
- minocycline
- usually around (300 mg)
- doxycycline
- tends to requires multiple doses
- tetracycline
- minocycline
- Corynebacterium parvum - Corynebacterium parvum pleurodesis
- mepacrine
- bleomycin
- povidone-iodine
- quinacrine hydrochloride (Atabrine)
