Figure 2.

Management of patients with known or suspected MPE. *, with goals of assessing lung expansion and relief of dyspnea. This step may not be necessary if the patient’s dyspnea is known to be attributable to the MPE; **, the recommendation of “Predicted very short survival” should be used as a rough guideline and individualized on a case-by-case basis; ***, there is a low likelihood of IPC—related infection. Escalation of care (intravenous antibiotics, hospital admission, removal of catheter) should be made on a case-by-case basis and is recommended if there are any signs/symptoms of worsening infection. Adapted from Ref. 42. Reprinted with permission of the American Thoracic Society. Copyright^© 2018 American Thoracic Society. MPE, malignant pleural effusion; IPC, indwelling pleural catheter