Silver Nitrate Is Superior to Talc Slurry in Producing Pleurodesis in Rabbits

摘要

Study objective: The ideal agent for producing pleurodesis has not been identified. Although talcnis the agent most commonly used at the present time, there are concerns about its safety. Silvernnitrate is a possible alternative agent. The purpose of the present study was to compare theneffectiveness of intrapleural silver nitrate and talc slurry in producing pleurodesis in rabbits.nAdditionally, the total amount of pleural collagen and the distribution of thick and thin collagennfibers were studied.nDesign: Two groups of 10 rabbits received either 0.50% silver nitrate or 400 mg/kg talc in a totalnvolume of 2 mL intrapleurally. The animals were killed 28 days after injection, and the pleuralnspaces were assessed grossly for evidence of pleurodesis and microscopically for evidence ofninflammation and fibrosis. Collagen was assessed with the van Gieson’s and picrosirius stains.nResults: The macroscopic pleurodesis (scale, 0 to 4; mean 6 SEM) resulting from the intrapleuralninjection of silver nitrate (3.4 6 0.2) was significantly better (p < 0.001) than that resulting fromntalc (1.6 6 0.1). The mean degree of microscopic pleural fibrosis induced by silver nitraten(3.3 6 0.3) was significantly higher (p 5 0.003) than that induced by talc (1.8 6 0.1). The meannamount of microscopic pleural collagen (van Gieson’s) was significantly greater (p < 0.001) in thenrabbits that received silver nitrate (3.0 6 0.2) than in those that received talc (1.6 6 0.2). Thendistribution of thick and thin collagen fibers did not differ between the groups.nConclusions: We conclude that, in our rabbit model, intrapleural silver nitrate was more effectiventhan talc in producing a pleurodesis. (CHEST 2000; 118:808–813)