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People with fluid around the lung from cancer can have a small tube left in to drain it at home. In two randomised trials, draining it every day rather than less often doubled or more than doubled how often the fluid stopped for good, without making breathlessness worse. The British guideline now recommends it where removing the tube matters to the person; how often it is offered is not measured.
Current practice. Home drainage is often done every other day, three times a week, or when breathless. The BTS guideline for pleural disease (2023) recommends daily drainage where catheter removal is a priority (conditional), and advises that daily drainage is not needed to control breathlessness (strong, by consensus).
The trials. ASAP randomised 149 people to daily or every-other-day drainage: autopleurodesis 47% against 24% (P = 0.003), with a shorter median time to it (54 against 90 days) and no difference in adverse events, quality of life or satisfaction. AMPLE-2 randomised 87 people to daily or symptom-guided drainage: breathlessness did not differ, spontaneous pleurodesis by 6 months was 44.2% against 15.9%, and EQ-5D-5L quality of life was better with daily drainage.
The gap. How often daily drainage is offered, and to whom, has not been measured.
Shares Knowledge reaches practice too slowly and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Pain relief and palliative care are unavailable to most and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Knowledge reaches practice too slowly and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Pain relief and palliative care are unavailable to most and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Knowledge reaches practice too slowly and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Knowledge reaches practice too slowly and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Knowledge reaches practice too slowly and the tags protocol-upgrade, upgrade:proven-unevenly-used.
Shares Knowledge reaches practice too slowly and the tags protocol-upgrade, upgrade:proven-unevenly-used.
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