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laboratory and animal investigations: Eduardo Campos Werebe, Rogério Pazetti, José Ribas Milanez de Campos, Paulo Pêgo Fernandez, Vera Luiza Capelozzi, Fábio Biscegli Jatene, and Francisco S. Vargas Systemic Distribution of Talc After Intrapleural Administration in Rats Chest 1999; 115: 190-193 [Abstract] [Full text] [PDF]

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Fatal outcome after talc poudrage

Michael-Rolf Mueller   (12 August 2001)

Fatal outcome after talc poudrage 12 August 2001
Michael-Rolf Mueller, thoracic surgeon University of Vienna Send letter to journal: Re: Fatal outcome after talc poudrage michael-rolf.mueller{at}akh-wien.ac.at Michael-Rolf Mueller	Dear Sir, I read your article with great interest and fully agree with your recommendation of a very restrictive use of talc in the pleural space. I want to confirm your observations with acute respiratory failure after talc poudrage for malignant effusions. We exclusively use talc for the treatment of massive and recurrent malignant effusion, never in patients with spontaneous pneumothorax. We generally use less than 5g, which is applied by means of VATS. We have used talc slurry for some years and now prefer the easier application with a spray device we normally use for distributing fibrin glue. In the last 16 years I have seen a number of patients with acute respiratory problems after such treatment, all but one recovered within 2 to 3 days. The one case was a 45 years old lady with unilateral malignant pleural effusion from breast cancer. Despite the restrictive effect of the effusion, which could be managed by repeated punture, she was in very good general condition. Within hours after talc poudrage she developed acute respiratory failure, had to be intubated and never came off the respirator.