#JustReleased: ATS/STS/STR 2018 Guideline For Mx of Malignan
American Thoracic Society (ATS), the Society of Thoracic Surgeons (STS), and the Society of Thoracic Radiology (STR), have jointly issued clinical practice guideline on the management of malignant pleural effusions (MPEs).

The guidance document has been published in the American Journal of Respiratory and Critical Care Medicine.
Because patients with MPE have a short survival period averaging only 4 to 7 months, and because the condition most often is associated with significant dyspnea, the guideline emphasizes patient-centred outcomes such as relieving dyspnea in a minimally invasive manner and reducing or eliminating the need for repeated procedures and health care visits.

Some of the key recommendations are:-
• In patients with MPE, ultrasonography should be used to guide pleural interventions.

• In patients with asymptomatic MPE, therapeutic pleural interventions should not be performed, although if pleural fluid is required for diagnostic purposes, fluid and/or tissue sampling would be appropriate.

• Patients with symptomatic MPE should undergo large-volume thoracentesis if it is uncertain whether the symptoms are related to the effusion and/or if the lung is expandable to assess lung expansion.

• In patients with MPE with suspected expandable lung and no prior definitive therapy, and whose symptoms are attributable to the effusion, either indwelling pleural catheters (IPCs) or chemical pleurodesis should be used as first-line definitive intervention for management of dyspnea.

• In patients with symptomatic MPE and expandable lung undergoing talc pleurodesis, either talc poudrage or talc slurry should be used.

• In patients with symptomatic MPEs with nonexpandable lung, failed pleurodesis, or loculated effusion, the use of IPCs over chemical pleurodesis is suggested.

• In patients with IPC-associated infections, treating through the infection without catheter removal is usually adequate, but catheter removal is suggested if the infection fails to improve.

About ATS
The American Thoracic Society (ATS) is the world's leading medical association dedicated to advancing our clinical and scientific understanding of pulmonary diseases, critical illnesses and sleep-related breathing disorders.

Note: This list is a brief compilation of some of the key points included in the guidelines and is not exhaustive and does not constitute medical advice. Kindly refer to the original publications here: https://pxmd.co/gG7FR and https://pxmd.co/yrcO9
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