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IPC Spontaneous Pleurodesis Rate — SCE Palliative Medicine MCQ

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HardRespiratory SymptomsIPC Spontaneous Pleurodesis RateSCE Palliative Medicine

A patient with an expandable lung has an indwelling pleural catheter for malignant effusion. Symptoms are controlled, but her priority is catheter removal as soon as feasible. Which drainage strategy should be discussed?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Daily IPC drainage to promote earlier spontaneous pleurodesis

When an expandable lung is present and catheter removal is a priority, BTS guidance supports discussing daily drainage because it increases pleurodesis and removal rates compared with symptom-guided drainage. If the main aim were symptom control with fewer procedures, drainage could remain symptom-led. Symptom control alone does not prove pleurodesis, and talc is not automatically required.

Reference: British Thoracic Society Clinical Statement on pleural procedures: https://www.brit-thoracic.org.uk/document-library/clinical-statements/pleural-procedures/pleural-procedures-full-supplement/