talc slurry for pleurodesis

Methods

  • use 4g Talc and 50cc saline
  • Inject saline in to Talc bottle, shake, pull fluid back out
  • Instill 2% lidocaine through chest tube
  • Instill all talc into chest tube with addition of 20cc saline flush
  • clamp for 1 hour
  • turn chest tube back to suction
  • Monitor for pain and add opioids if needed
  • Monitor for ARDS and SIRS response

Complications

  • is very very painful

Caveats

  • low success rate with high pleural fluid output
  • low success rate with high pH and LDH
  • about 80% success rates with pneumothorax
  • success rates comparable between talc poudrage and slurry