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Chemical Pleurodesis
Pleurodesis is a procedure that obliterates the pleural
space in order to prevent recurrent pleural effusion or
recurrent pneumothorax. It is most commonly performed
by draining the effusion or intrapleural air and then
instilling a chemical irritant into the pleural space, which
induces inflammation and fibrosis. This is known as
chemical pleurodesis. Common questions about chemical
pleurodesis include:
• What are the indications for chemical pleurodesis?
• What are the contraindications?
• Which chemical irritant should be used?
Indications:
Chemical pleurodesis has been used to manage
malignant pleural effusions, refractory nonmalignant
pleural effusions, and pneumothorax.
Contraindications:
Pleurodesis will certainly fail if the lung cannot fully
expand (e.g. lung entrapment) because successful
pleurodesis requires contact of the visceral and parietal
pleura. Thus, chemical pleurodesis should not be
attempted in this setting.
1
Medical Chemistry Assignment
By: Noor Al-Deen M. Al-Khanati
Choice of Agent:
Numerous chemical irritants have been used to induce
pleurodesis including: talc, tetracycline, minocycline,
doxycycline, Corynebacterium parvum, fluorouracil,
methylprednisolone acetate, bleomycin, interferon beta,
mitomycin C, cisplatin, cytarabine, doxorubicin,
etoposide, and Streptococcus pyogenes A3 (OK-432).