Clinical Trial: Impact of Aggressive Versus Standard Drainage Regimen Using a Long Term Indwelling Pleural Catheter

Study Status: Completed
Recruit Status: Completed
Study Type: Interventional

Official Title: Impact of Aggressive Versus Standard Drainage Regimen Using a Long Term Indwelling Pleural Catheter on the Incidence of Auto-Pleurodesis in Patients With Malignant Pleural Effusi

Brief Summary: Purpose and Objective: The purpose of this study is to determine if the rate of spontaneous pleurodesis using the Pleurx® catheter could be increased by simply increasing the frequency of pleural drainage and, if so, whether catheter-related complications can be minimized and spare patients the need for long term management of the Pleurx® catheter.

Detailed Summary:

Study Population: Patients greater than 18 years of age with malignant pleural effusions will be identified and approached in clinic by the Principle and Co-Investigator. Informed consent will be obtained from qualified and interested patients.

Study Activities: Patients will be randomized to standard and aggressive drainage groups and complete questionnaires regarding their health. Patients will then receive the Pleurx® catheter for standard treatment of their malignant pleural effusions, obtain a chest-xray, and receive educational instruction and training on catheter drainage and told whether to drain everyday using a 1-liter bottle or every other day using a 600-cc bottle. Patients will complete a drainage diary on everyday they drain fluid which will provide information on drainage volume, fluid color, pain, and complications. At 2 weeks, 6 weeks, and 12 weeks post catheter placement, patients will return to clinic for follow-up at which time they will have an interval history and physical and chest xray and complete a questionnaires regarding their health and satisfaction.

Risks/Safety Issues: Risks associated with draining the catheter include: pneumothorax, re-expansion pulmonary edema, hypotension, circulatory collapse, and infection. All serious adverse events will be reported to the institutional review board: a) death - immediately; b) life-threatening within 7 calendar days; c) all other SAEs (serious adverse events) within 15 calendar days. Should there be a serious adverse event that occurs that increases the risk to the participants, the study will be stopped, an investigation will be conducted, and a findings report will be generated before the study is resumed.

Data Analysis: The principal endpoint is the incidence of successful pleurodesis utilizing
Sponsor: Duke University

Current Primary Outcome: To compare the incidence of auto-pleurodesis utilizing aggressive drainage versus standard drainage protocols with the PleuRx® catheter [ Time Frame: 2, 6, and 12 weeks post-catheter insertion ]

Original Primary Outcome: Same as current

Current Secondary Outcome:

  • To determine the median time to auto-pleurodesis utilizing aggressive drainage versus standard drainage protocols with the PleuRx® catheter [ Time Frame: 2, 6, and 12 weeks post-catheter insertion ]
  • To assess the effects of aggressive drainage versus standard drainage protocols with the PleuRx® catheter on functional health status [ Time Frame: 2, 6, and 12 weeks post-catheter insertion ]
  • To determine predictors of auto-pleurodesis (volume and rate of pleural fluid drainage, biochemical, and radiographic) using post-hoc analysis in both the aggressive and standard drainage protocols [ Time Frame: 2, 6, and 12 weeks post-catheter insertion ]
  • To determine patient and caregivers' satisfaction with the PleuRx® catheter using a questionnaire [ Time Frame: 2, 6, and 12 weeks post-catheter insertion ]


Original Secondary Outcome: Same as current

Information By: Duke University

Dates:
Date Received: September 15, 2009
Date Started: August 2009
Date Completion:
Last Updated: December 27, 2013
Last Verified: December 2013