Efficacy and safety of iodopovidone pleurodesis in malignant pleural effusions.
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.
Neto
Jose D A
JD
Department of Thoracic Surgery of Hospital Aristides Maltez, Salvador, BA, Brazil.
de Oliveira
Sandro F Q
SF
Vianna
Sylvana P
SP
Terra
Ricardo M
RM
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage; D016724:Empyema, Pleural / Q000188:drug therapy; D005260:Female; D006801:Humans; D008012:Lidocaine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000139:chemically induced / Q000188:drug therapy; D016066:Pleural Effusion, Malignant / Q000188:drug therapy*; D018700:Pleurodesis / Q000009:adverse effects / Q000379:methods*; D011206:Povidone-Iodine / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D011206:Povidone-Iodine; D008012:Lidocaine