1.Describe the indications for PleurX® catheter placement.2.Describe the benefits of PleurX® catheter placement compared with repeated thoracocentesis or standard chest tube placement. The PleurX® catheter is indicated for drainage of symptomatic, recurrent, pleural effusions that are unresponsive to medical management. We sought to and evaluate the effectiveness of the use of PleurX® catheters for pediatric patients with malignant effusions. We performed a retrospective review of the medical records of pediatric oncology patients at our institution who underwent PleurX® catheter placement for palliation of symptoms due to malignant effusions. Over a 2-year period, five patients (ages 6-17 years) with metastatic malignancy underwent PleurX® catheter placement. All had symptomatic malignant pleural effusions. One patient also had symptomatic malignant ascites. Four of 5 patients had recurrent disease; all had refractory, widely metastatic disease. Their underlying diagnoses included large B cell lymphoma, Ewing’s sarcoma, rhabdomyosarcoma, adenocarcinoma, and atypical teratoid rhabdoid tumor. Three of 5 patients were discharged from the hospital with the PleurX® catheter. Family caregivers of these 3 patients were able to operate the drainage system at home. The mean duration of PleurX® catheter placement was 39 +/- 34 days (range 2–73 days). The mean survival after PleurX® catheter placement was 69 +/- 89 days (range 2–219 days). PleurX® placement was well-tolerated by all 5 patients. One patient underwent PleurX® removal without recurrent pleural effusions. No patient required PleurX® removal due to catheter-associated complication or infection. For pediatric patients with limited life expectancy due to refractory metastatic malignancy, the PleurX® catheter appears to be a promising alternative to repeated thoracocentesis or the use of standard chest tubes that severely limit mobility and prolong hospitalization. For 3 of 5 pediatric patients, PleurX® catheter placement facilitated hospital discharge and increased time spent at home. In addition, the PleurX® catheters were able to be managed effectively by family caregivers.