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

2000; Elsevier BV; Volume: 118; Issue: 3 Linguagem: Inglês

10.1378/chest.118.3.808

1931-3543

Francisco S. Vargas, Lisete R. Teixeira, Marcelo A.C. Vaz, Alipio O. Carmo, Evaldo Marchi, Patrı́cia Maluf Cury, Richard W. Light,

Medical and Biological Ozone Research

Study objective The ideal agent for producingpleurodesis has not been identified. Although talc is the agent mostcommonly used at the present time, there are concerns about its safety. Silver nitrate is a possible alternative agent. The purpose of thepresent study was to compare the effectiveness of intrapleural silvernitrate and talc slurry in producing pleurodesis in rabbits. Additionally, the total amount of pleural collagen and the distributionof thick and thin collagen fibers were studied. Design Two groups of 10 rabbits received either 0.50% silver nitrate or 400 mg/kg talc in a total volume of 2 mLintrapleurally. The animals were killed 28 days after injection, and the pleural spaces were assessed grossly for evidence of pleurodesisand microscopically for evidence of inflammation and fibrosis. Collagenwas assessed with the van Gieson’s and picrosirius stains. Results The macroscopic pleurodesis (scale, 0 to 4;mean ± SEM) resulting from the intrapleural injection of silvernitrate (3.4 ± 0.2) was significantly better (p < 0.001) thanthat resulting from talc (1.6 ± 0.1). The mean degree of microscopicpleural fibrosis induced by silver nitrate (3.3 ± 0.3) wassignificantly higher (p = 0.003) than that induced by talc(1.8 ± 0.1). The mean amount of microscopic pleural collagen (vanGieson’s) was significantly greater (p < 0.001) in the rabbits thatreceived silver nitrate (3.0 ± 0.2) than in those that received talc(1.6 ± 0.2). The distribution of thick and thin collagen fibers didnot differ between the groups. Conclusions Weconclude that, in our rabbit model, intrapleural silver nitrate wasmore effective than talc in producing a pleurodesis. The ideal agent for producingpleurodesis has not been identified. Although talc is the agent mostcommonly used at the present time, there are concerns about its safety. Silver nitrate is a possible alternative agent. The purpose of thepresent study was to compare the effectiveness of intrapleural silvernitrate and talc slurry in producing pleurodesis in rabbits. Additionally, the total amount of pleural collagen and the distributionof thick and thin collagen fibers were studied. Two groups of 10 rabbits received either 0.50% silver nitrate or 400 mg/kg talc in a total volume of 2 mLintrapleurally. The animals were killed 28 days after injection, and the pleural spaces were assessed grossly for evidence of pleurodesisand microscopically for evidence of inflammation and fibrosis. Collagenwas assessed with the van Gieson’s and picrosirius stains. The macroscopic pleurodesis (scale, 0 to 4;mean ± SEM) resulting from the intrapleural injection of silvernitrate (3.4 ± 0.2) was significantly better (p < 0.001) thanthat resulting from talc (1.6 ± 0.1). The mean degree of microscopicpleural fibrosis induced by silver nitrate (3.3 ± 0.3) wassignificantly higher (p = 0.003) than that induced by talc(1.8 ± 0.1). The mean amount of microscopic pleural collagen (vanGieson’s) was significantly greater (p < 0.001) in the rabbits thatreceived silver nitrate (3.0 ± 0.2) than in those that received talc(1.6 ± 0.2). The distribution of thick and thin collagen fibers didnot differ between the groups. Weconclude that, in our rabbit model, intrapleural silver nitrate wasmore effective than talc in producing a pleurodesis.