・チと古いですが，ランセットに以下のような論文がありました．タルクを使って胸膜癒着術をおこなった症例の１～9％にARDS（急性呼吸窮迫症候群）がおこる？？？
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(07)60708-9/abstract
The Lancet, Vol. 369, Issue 9572, Pages 1535 - 1539, 5 May 2007
Safety of pleurodesis with talc poudrage in malignant pleural effusion: a prospective cohort study
Dr Julius P Janssen, et ali.
Summary
Background
Talc is the most effective chemical pleurodesis agent for patients with malignant pleural effusion. However, concerns have arisen about the safety of intrapleural application of talc, after reports of development of acute respiratory distress syndrome in 1—9% of treated patients. Our aim was to establish whether use of large-particle-size talc is safe in patients with malignant pleural effusion.
Methods
We did a multicentre, open-label, prospective cohort study of 558 patients with malignant pleural effusion who underwent thoracoscopy and talc poudrage with 4 g of calibrated French large-particle talc in 13 European hospitals, and one in South Africa. The primary endpoint was the occurrence of acute respiratory distress syndrome after talc pleurodesis.
Findings
No patients developed acute respiratory distress syndrome (frequency 0%, one-sided 95% CI 0—0·54%). 11 (2%) patients died within 30 days. Additionally, seven patients had non-fatal post-thoracoscopy complications (1·2%), including one case of respiratory failure due to unexplained bilateral pneumothorax.
Interpretation
Use of large-particle talc for pleurodesis in malignant pleural effusion is safe, and not associated with the development of acute respiratory distress syndrome.
・ＡＲＤＳを起こすのは，粒子の小さいタルクで大きいものは安全なようです．私はタルクで胸膜癒着術を行った経験がないのですが，もしタルクを使用するならその産地／粒の大きさをチェックしておいた方が良さそうですね．
・ところでタルク（＝滑石）とは，何だという方は，下のWikipediaの説明見てください．この説明にも書いていますが，タルクに石綿が混入していることがあるのでご注意を．
http://ja.wikipedia.org/wiki/%E3%82%BF%E3%83%AB%E3%82%AF
