Efficacy and safety of iodopovidone pleurodesis in malignant pleural effusions

• Published in: Respirology (Carlton, Vic.) Vol. 15; no. 1; pp. 115 - 118
• Main Authors: NETO, Jose D.A., De OLIVEIRA, Sandro F.Q., VIANNA, Sylvana P., TERRA, Ricardo M.
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Publishing Asia 01-01-2010
• Subjects: Adult; Aged; Anti-Bacterial Agents - therapeutic use; Drainage; efficacy; Empyema, Pleural - drug therapy; Female; Humans; iodopovidone; Lidocaine - therapeutic use; Male; malignant pleural effusion; Middle Aged; Pain, Postoperative - chemically induced; Pain, Postoperative - drug therapy; Pleural Effusion, Malignant - drug therapy; pleurodesis; Pleurodesis - adverse effects; Pleurodesis - methods; Povidone-Iodine - administration & dosage; Retrospective Studies; safety; Treatment Outcome
• DOI: 10.1111/j.1440-1843.2009.01663.x
• EISSN: 1440-1843
• ISSN: 1323-7799

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.
This was a retrospective analysis of iodopovidone pleurodesis in patients with malignant pleural effusions. There was no recurrence of pleural fluid after iodopovidone pleurodesis. The most common complication was mild thoracic pain. Empyema occurred in one patient. Iodopovidone demonstrated good efficacy and safety, suggesting it is a useful alternative agent for pleurodesis.