Pleural Effusion Treatment Protocol

Eligible patients were admitted into the hospital for treatment on protocol. The pleural effusion was drained via insertion of a chest tube or pleural catheter (PleurX™ Catheter, Becton, Dickinson and Company, Franklin Lakes, NJ). A chest CT scan was performed to document drainage of the effusion and to assess the extent of pleural disease. Within 72 hours of the CT scan, the virus was instilled as a bolus into the pleural space via the chest tube or pleural catheter. Up to 150 ml of additional saline was used to flush the chest tube or pleural catheter to ensure that all the treatment drug was instilled into the pleural space. The chest tube or pleural catheter was left clamped for 4 hours (+/- 1 hour), after which it was reopened and placed to drainage in order to drain the pleural space. As dictated by the patient’s clinical status, the chest tube was either left inserted or removed until the surgical procedure (video-assisted thoracoscopic surgery, VATS) was performed 2-7 days after treatment to collect MPE and obtain pleural biopsy.