2018ATS_STS_STR临床实践指南_恶性胸腔积液的管理.pdf

AMERICAN THORACIC SOCIETY DOCUMENTS Management of Malignant Pleural Effusions An Official ATS/STS/STR Clinical Practice Guideline David J. Feller-Kopman*, Chakravarthy B. Reddy*, Malcolm M. DeCamp, Rebecca L. Diekemper, Michael K. Gould, Travis Henry, Narayan P. Iyer, Y. C. Gary Lee, Sandra Z. Lewis, Nick A. Maskell, Najib M. Rahman, Daniel H. Sterman, Momen M. Wahidi, and Alex A. Balekian; on behalf of the American Thoracic Society, Society of Thoracic Surgeons, and Society of Thoracic Radiology THIS OFFICIAL CLINICAL PRACTICE GUIDELINE WAS APPROVED BY THE AMERICAN THORACIC SOCIETY OCTOBER 2018, THE SOCIETY OF THORACIC SURGEONS JUNE 2018, AND THE SOCIETY OF THORACIC RADIOLOGY JULY 2018 Background: This Guideline, a collaborative effort from the MPE; 3) using either an indwelling pleural catheter (IPC) or American Thoracic Society, Society of Thoracic Surgeons, and chemical pleurodesis in symptomatic patients with MPE and Society of Thoracic Radiology, aims to provide evidence-based suspected expandable lung; 4) performing large-volume recommendations to guide contemporary management of patients thoracentesis to assess symptomatic response and lung expansion; with a malignant pleural effusion (MPE). 5) using either talc poudrage or talc slurry for chemical pleurodesis; 6) using IPC instead of chemical pleurodesis in patients with Methods: A multidisciplinary panel developed seven questions nonexpandable lung or failed pleurodesis; and 7) treating using the PICO (Population, Intervention, Comparator, and IPC-associated infections with antibiotics and not removing the Outcomes) format. The GRADE (Grading of Recommendations, catheter. Assessment, Development and Evaluation) approach and the Evidence to Decisi