Napcon Specialists Highlight Data-Driven Approaches and Clinical Guidelines for Recurrent and Non-Malignant Pleural Effusions

News Desk, News Nation 360: During NAPCON 2026 (28th National Conference of pulmonary diseases), some of the most respected pulmonologists, critical care physicians and thoracic experts reached consensus on the management of complicated NMPE and MPE with significant organ failure and high re-admission rates. During the session on "Recurrent pleural effusions -Diagnostic issues and treatment options" (Moderated by Dr Subhasis Ghosh), it was highlighted that initial optimisation of medical therapy for underlying organ failure (e.g. targeted diuretics for CHF over 72 hrs, aggressive stabilisation of liver failure) should be carried out before considering invasive drainage. >2-3 aspirations should be avoided as they can lead to significant protein loss, immunosuppression and catabolism. TIPS and liver transplant should be considered as first-line options rather than use of IPC due to the risk of life-threatening infective peritonitis in end-stage liver disease. Additionally, the TAP-IT and REDUCE trial data (Presented by Dr Rahul Tyagi) were compared to determine whether IPC or talc pleurodesis should be used. It was noted that IPC must be used for non-expandable lungs and reduces inpatient bed days. However, talc pleurodesis has a higher success rate in expandable lungs with longer life expectancy. Hybrid approaches are now available where talc can be administered in outpatients via an IPC. This results in quick pleurodesis (<35 days) and therefore significantly reduces inpatient burden.

Pic: Courtesy