Contemporary Pleural Drainage in Adult Practice: Image-Guided Techniques, Procedural Safety, Training Standards, and Malignant Pleural Effusion Management
This review provides a practical overview of contemporary pleural drainage, covering indications, procedural techniques, imaging guidance, complication prevention, training requirements, and the management of malignant pleural effusions. The authors highlight that despite advances in pleural drainage technology and practice, complications remain common and are often linked to operator inexperience and suboptimal insertion techniques. Current guideline recommendations emphasize routine ultrasound guidance, avoidance of trocar insertion, and the preferential use of appropriately sized small-bore drains for most non-traumatic pleural conditions. The review offers a clinician-focused framework for safe and effective pleural drainage while identifying ongoing challenges and areas of evolving practice.
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