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The Journal of Thoracic and Cardiovascular Surgery, Vol 85, 523-526, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
JE Rinaldo, GR Owens and RM Rogers
After intrapleural instillation of talc for sclerosis of malignant pleural
effusions, dyspnea occurred in three patients, progressed gradually over 72
hours, and culminated in acute respiratory failure characterized by
bilateral diffuse pulmonary infiltrates with normal pulmonary artery
occlusion pressures. Two patients recovered and one died. The chronological
similarity of the sequence of fever, dyspnea, and respiratory failure in
the absence of documented infection or other conditions that predispose to
the adult respiratory distress syndrome (ARDS) suggests that intrapleural
talc may have induced the syndrome in these patients through unknown
mechanisms. This experience emphasizes that other agents are preferable for
initial attempts to promote pleural symphysis in the palliation of
recurrent malignant effusions. When talc is used in patients who are
unresponsive to tetracycline, we suggest clinical monitoring for
respiratory compromise for 72 hours after the procedure.
ARTICLES
Adult respiratory distress syndrome following intrapleural instillation of talc
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