Medico Pediatra
Páginas: 3 (552 palabras)
Publicado: 11 de febrero de 2013
JAMA. 2012 Jun 13;307(22):2383-9. doi: 10.1001/jama.2012.5535.
Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleuraleffusion: the TIME2 randomized controlled trial.
Davies HE, Mishra EK, Kahan BC, Wrightson JM, Stanton AE, Guhan A, Davies CW, Grayez J, Harrison R, Prasad A, Crosthwaite N, Lee YC, Davies RJ,Miller RF, Rahman NM.
Source
Department of Respiratory Medicine, University Hospital of Wales, Cardiff, Wales.
Abstract
CONTEXT:
Malignant pleural effusion causes disabling dyspneain patients with a short life expectancy. Palliation is achieved by fluid drainage, but the most effective first-line method has not been determined.
OBJECTIVE:
To determine whether indwellingpleural catheters (IPCs) are more effective than chest tube and talc slurry pleurodesis (talc) at relieving dyspnea.
DESIGN:
Unblinded randomized controlled trial (Second TherapeuticIntervention in Malignant Effusion Trial [TIME2]) comparing IPC and talc (1:1) for which 106 patients with malignant pleural effusion who had not previously undergone pleurodesis were recruited from 143 patientswho were treated at 7 UK hospitals. Patients were screened from April 2007-February 2011 and were followed up for a year.
INTERVENTION:
Indwelling pleural catheters were inserted on anoutpatient basis, followed by initial large volume drainage, education, and subsequent home drainage. The talc group were admitted for chest tube insertion and talc for slurry pleurodesis.
MAIN OUTCOMEMEASURE:
Patients completed daily 100-mm line visual analog scale (VAS) of dyspnea over 42 days after undergoing the intervention (0 mm represents no dyspnea and 100 mm represents maximum dyspnea;10 mm represents minimum clinically significant difference). Mean difference was analyzed using a mixed-effects linear regression model adjusted for minimization variables.
RESULTS:
Dyspnea...
Effect of an indwelling pleural catheter vs chest tube and talc pleurodesis for relieving dyspnea in patients with malignant pleuraleffusion: the TIME2 randomized controlled trial.
Davies HE, Mishra EK, Kahan BC, Wrightson JM, Stanton AE, Guhan A, Davies CW, Grayez J, Harrison R, Prasad A, Crosthwaite N, Lee YC, Davies RJ,Miller RF, Rahman NM.
Source
Department of Respiratory Medicine, University Hospital of Wales, Cardiff, Wales.
Abstract
CONTEXT:
Malignant pleural effusion causes disabling dyspneain patients with a short life expectancy. Palliation is achieved by fluid drainage, but the most effective first-line method has not been determined.
OBJECTIVE:
To determine whether indwellingpleural catheters (IPCs) are more effective than chest tube and talc slurry pleurodesis (talc) at relieving dyspnea.
DESIGN:
Unblinded randomized controlled trial (Second TherapeuticIntervention in Malignant Effusion Trial [TIME2]) comparing IPC and talc (1:1) for which 106 patients with malignant pleural effusion who had not previously undergone pleurodesis were recruited from 143 patientswho were treated at 7 UK hospitals. Patients were screened from April 2007-February 2011 and were followed up for a year.
INTERVENTION:
Indwelling pleural catheters were inserted on anoutpatient basis, followed by initial large volume drainage, education, and subsequent home drainage. The talc group were admitted for chest tube insertion and talc for slurry pleurodesis.
MAIN OUTCOMEMEASURE:
Patients completed daily 100-mm line visual analog scale (VAS) of dyspnea over 42 days after undergoing the intervention (0 mm represents no dyspnea and 100 mm represents maximum dyspnea;10 mm represents minimum clinically significant difference). Mean difference was analyzed using a mixed-effects linear regression model adjusted for minimization variables.
RESULTS:
Dyspnea...
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