Respiratory failure following talc pleurodesis

BACKGROUND: Sterile talc is currently the agent of choice for pleurodesis. Its success rate is excellent, and talc is generally well tolerated. Howeve r, a recent experience with fulminant pneumonitis following talc pleurodesi s prompted a review of our experience. METHODS: A retrospective review of patients undergoing talc pleurodesis at our institution between December 1993 and December 1997 was performed, docu menting respiratory and other complications. Statistical analysis was perfo rmed using Student's t test and Pearson correlations RESULTS: Seventy-eight patients received 89 talc pleurodesis procedures. Re spiratory complications or death occurred in 33%; 9% of patients developed adult respiratory distress syndrome. There was no statistical difference in outcomes between patient groups, methods of application, or talc dosages u tilized. CONCLUSIONS: This series revealed a significantly higher rate of serious co mplications than that reported in the current literature, without implicati ng a clear reason for these outcomes. Our data raise questions about the sa fety of talc pleurodesis. Am J Surg. 1999;177:437-440. (C) 1999 by Excerpta Medica, Inc.