The search for an 'ideal' agent for
pleurodesis continues. Iodopovidone is a topical
antiseptic and has been shown to be safe and effective in many studies. The aim of this study was to evaluate the efficacy and safety of iodopovidone as an agent for chemical
pleurodesis. We performed a systematic review of all the observational trials which have used iodopovidone for chemical
pleurodesis. Six studies including 265 patients who had undergone chemical
pleurodesis with iodopovidone were included for this analysis. Iodopovidone was used for variety of indications, which included
pleural effusion (157 patients), and
pneumothorax (108 patients).
Pleurodesis was performed through tube
thoracostomy in 144 patients and through thoracoscopy in 121 patients. The success rate of
pleurodesis varied from 64.2% to 100%, and summary success rate of all the studies was 90.6% (95% confidence intervals [CI], 86.4-93.8). The success rate was independent for the procedure (tube
thoracostomy [126/144; 87.5%, 95% CI 80.9-92.4] or thoracoscopy [114/121; 94.2%, 95% CI 88.4-97.6]) used for performing
pleurodesis or for the indication (
pleural effusion [139/157; 88.5%, 95% CI 82.5-93.1] or
pneumothorax [101/108; 93.5%, 95% CI 87.1-97.4]). The only significant complication reported was
chest pain of varying degree. Systemic
hypotension was reported in three patients in only one study. There were no deaths related to chemical
pleurodesis with iodopovidone. Overall, this review supports the safety and efficacy of iodopovidone as an agent for chemical
pleurodesis in cases of recurrent
pleural effusions and pneumothoraces regardless of their etiology.