Impact of Indwelling Tunneled Pleural Drainage Systems (Gravity or Vacuum Based) on Pain in Patients with Recurrent Pleural Effusions

Inclusion Criteria

• Clinical indications for placement of IPC for malignant pleural effusion * Pleural effusion with symptomatic improvement in dyspnea after drainage of ipsilateral effusion
• Clinically confident symptomatic malignant pleural effusion * Histocytological proof of pleural malignancy * Recurrent large pleural effusion in context of histologically proven cancer outside the pleural space
• Plans for placement of IPC within ten days of enrollment
• Sufficient fluid on ultrasound to allow for safe insertion of IPC

Exclusion Criteria

• Recent (less than 60 days) thoracic surgery or chest trauma causing chronic pain
• Pregnant or lactating mothers
• Previous ipsilateral chemical pleurodesis
• Current contralateral indwelling pleural catheter
• Known rib or thoracic skeletal metastasis causing pain
• Concern for active pleural infection
• Respiratory failure
• Irreversible bleeding diathesis
• Inability to provide care for indwelling tunneled pleural catheter
• Significantly loculated pleural space precluding drainage of pleural space, for which IPC alone will likely not offer symptomatic benefit
• Estimated life expectancy of < 30 days (however, active enrollment in hospice program is not an exclusion criteria)
• Inability to read/understand/write in the English language
• Inability to follow-up for appointments/protocol
• Subject has any clinical condition, diagnosis, or social circumstance that, in the opinion of the investigator would mean participation in the study would be contraindicated
• Enrollment in alternative pleural catheter trial that would preclude enrollment within this trial