Efficacy and safety of iodopovidone pleurodesis in malignant pleural effusions.

Abstract

BACKGROUND AND OBJECTIVE:

Pleurodesis is one of the best methods of controlling malignant pleural effusions (MPE), a distressing complication of metastatic disease. In recent studies of a wide range of pleural diseases, iodopovidone was used as a sclerosing agent for pleurodesis and demonstrated good results with low morbidity. The aim of this study was to evaluate the efficacy and safety of iodopovidone pleurodesis in MPE.

METHODS:

A retrospective analysis was performed on patients with MPE who underwent pleurodesis at our institution between 2005 and 2008. All patients underwent instillation of 20 mL of 10% iodopovidone, 80 mL of normal saline and 2 mg/kg of lidocaine through a chest tube, which was clamped for 2 h. The tube was removed when the daily output of fluid was <200 mL. Data on the requirement for additional pleural procedures, adverse events and survival were collected.

RESULTS:

Sixty-one pleurodesis procedures were performed in 54 patients. No procedure-related mortality was observed. Adverse events occurred after 11 (18%) pleurodesis procedures. The most frequent complication was mild thoracic pain that occurred immediately after 10 (16.4%) procedures, and one patient developed pleural empyema that was treated with drainage and antibiotics. A success rate of 98.4% was observed. Except for the patient who developed pleural empyema, none of the other patients had recurrences of pleural fluid or required additional pleural procedures during the follow-up period (mean of 5.6 months).

CONCLUSIONS:

Iodopovidone pleurodesis was successful and was associated with only a few minor complications. It appears to be a good option for the management of recurrent MPE.

• Authors: Jose D A Neto, Sandro F Q de Oliveira, Sylvana P Vianna, Ricardo M Terra
• Journal: Respirology (Carlton, Vic.) (Respirology) Vol. 15 Issue 1 Pg. 115-8 (Jan 2010) ISSN: 1440-1843 [Electronic] Australia
• PMID: 19947987 (Publication Type: Evaluation Study, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Povidone-Iodine
• Lidocaine

Topics

• Adult
• Aged
• Anti-Bacterial Agents (therapeutic use)
• Drainage
• Empyema, Pleural (drug therapy)
• Female
• Humans
• Lidocaine (therapeutic use)
• Male
• Middle Aged
• Pain, Postoperative (chemically induced, drug therapy)
• Pleural Effusion, Malignant (drug therapy)
• Pleurodesis (adverse effects, methods)
• Povidone-Iodine (administration & dosage)
• Retrospective Studies
• Treatment Outcome