Malignant Pleural Effusion End Of Life

Malignant Pleural Effusion End Of Life

Malignant pleural effusion end of life - Pleural effusion is defined as an abnormal amount of fluid in the space between the layers of tissue (pleura), which lines the lungs. If there are cancer cells present in fluid (the pleural cavity), pleural effusion called malignant (cancer). Malignant pleural effusion can be extensive, diffuse or small and covers only a tiny fraction of the cavity of the pleura. Effusion may occur in one area, or there may be some areas effusion (pleural effusion).

Malignant pleural effusion is complexity, which involves the accumulation of fluid containing cancer cells between the membranes, which form the lungs. Malignant pleural effusion end of life - This occurs in about 30 percent of lung cancers, but may also occur with other cancers, such as breast cancer, ovarian cancer, leukemia, and lymphoma. With lung cancer can be a malignant pleural effusion the first sign of cancer, or may occur as the complexity of advanced carcinoma of the lung.

Symptoms of a malignant pleural statement can be very uncomfortable. The most common symptom is a very short breath, which occurs in about 80% of the population. There may be a cough, and you are often positional, which means that the coughing is worse at certain places, for example, the clone forward or lying on one side. Can occur and pressure on the breasts or a particular type of abnormal perception.

What causes pleural effusion? Almost all types of cancer can cause pleural effusion, if someone or spread (metastasize) into the chest area. The most common is breast cancer, lung cancer, ovarian cancer and some types of leukemia and lymphoma. Pleural effusion can also be caused by treatment for lung cancer, as surgical surgery, radiation therapy or chemotherapy. Malignant pleural effusion is the progress of the disease, which affects about 15 percent of patients with cancer. Malignant pleural effusion end of life - It happened every year in the approximately 150 000 Americans with cancer, and they are generally associated with poor views.

Malignant Pleural Effusion End Of Life

In healthy subjects, the pleural space 1 ml of pleural fluid (10% of healthy people can be obtained by thoracocentesis). The mission of this fluid is to act as a lubricant between the surfaces visceral and parietal pleura. It consists of 1.5 g/dl of protein electrophoresis patterns similar content of plasma albumin, although a smaller and globulin and fibrinogen b are slightly higher. The volume and the composition of the liquid remain constant in relation to the internal permeability of the membrane and the balance of hydrostatic pressure and Oncotic is determined by the law of Starling. See also: Pleural Effusion Cancer Life Expectancy.

Systemic arteries, which feed the parietal pleura the visceral pleura, you will receive a temporary vascularity pulmonary the circulation pressure. The liquid flowing out of the tip of the capillary arteries of the parietal pleura and is absorbed mainly at the ends of the capillary vein of the pleura. On the individual normal systemic capillary hydrostatic gradient arises about 9 cm. the water that supports the capillary transudate pleural effusion in the space. Gradient Oncotic almost 10 cm. water promotes the absorption of this fluid from the pleural space into the capillaries of the visceral pleura, while this space is relatively free of liquid content.

The DPM generated by changes in the pleura spaces into the lymphatic drainage system due to parietal pleura stoma, lymph obstruction due to the involvement of the mediastinum, increased capillary permeability substances vasoactive anti-neoplastic activities or embolization cells the anti-neoplastic activities on visceral pleura. Patients oncologists can discover the switch, and due to other causes than the mere novoplazma (syndrome nephrotic, heart failure, pulmonary Emboli, hipoalbuminémie etc.). Only 50% of the pleura statement was made in patients with cancer during the development of their disease was malignant.

In 50% of cases is pleural effusion the first manifestation of the metastatic disease. In 90% of patients with primary or metastatic pleura tumors is the PD of the first manifestation. When diagnosed 77% of patients have symptoms. Dyspnea was the most common symptom and is associated with pain and cough. Malignant pleural effusion end of life - Dyspnea was caused by a combination of compression of the thoracic cavity, the depression, the displacement of the diaphragm agenesis of the mediastinum and reduction of lung volumes neurogenic reflex stimulation.

And what's the prognosis? The overall prognosis of patients with GKG is bad. Most of them have a medium survival of 3 to 6 months. The most important prognostic factors are: the type of neoplasia and the sensitivity against antineoplastic therapy, performance status, metastatic extension, and some authors give the negative value of the value of pleura flo fluidized less than 7.28, if there is no related infection.

How is it done? The goal of treatment malignant pleural effusion is most often a palliative nature, namely the improvement of the quality of life and control symptoms but do not treat malignancy. If it is effusion very small, it can sometimes be left alone.

1. Thoracentesisesis. Thoracentesisesis is usually the first step, which is used, either to the diagnosis of the effusion (to determine whether cancer cells are present in the liquid and larger), and that the liquid removed. Unfortunately this effusion often returns.

In malignant pleural effusion, which is repeated, there are several treatment options fluid and to reduce the shortage of breath. Currently, there is still significant controversy about the procedure, which is the best, and the choice is often made on the basis of the severity of the symptoms, how cancer respond to treatment and your performance status (how many cancer impairs your ability to perform normal daily activities).

2. Pleurodesis. The procedure, which works in about 60 to 90 percent of the people called pleurodesis. Malignant pleural effusion end of life - In this procedure is to pleura space inserted tube and to it is added a substance, usually a powder, and inserted between the two membranes, which form the lungs. These chemicals cause inflammation of the pleural cavity, which causes the two layers to each other glued together (fuse) to the liquid accumulated in the pleural space back. Possible complications with pleura resemble Thoracentesisesis.

3. pleural synod settled. The next procedure is a pleural catheter inside (IPC), which is also known as a pleural catheter. In this procedure was to pleurního space is inserted a small tube, which is under the skin went through, with a little hole on the side, which can be covered with a bandage. It allows people to drain the fluid yourself by connecting the vacuum vessel to an opening in the skin.

IPC is sometimes more efficient if it is on both sides of the breast present výprk (bilateral) or if there are large areas for the collection of localized fluid (effusion localized). This procedure is often considered to be less invasive than pleurodesis and effective at 80% up to 100 percent of the population. Malignant pleural effusion end of life - Many researchers today feel that the IPC will be considered the first line of all the people with the malignant range.