Efficacy and safety of iodopovidone pleurodesis in malignant pleural effusions

  1. Jose D.A. NETO1,
  2. Sandro F.Q. De OLIVEIRA1,
  3. Sylvana P. VIANNA1,
  4. Ricardo M. TERRA2,*

Article first published online: 23 NOV 2009

DOI: 10.1111/j.1440-1843.2009.01663.x

Issue

Respirology

Respirology

Volume 15, Issue 1, pages 115–118, January 2010

Additional Information

How to Cite

NETO, J. D., De OLIVEIRA, S. F., VIANNA, S. P. and TERRA, R. M. (2010), Efficacy and safety of iodopovidone pleurodesis in malignant pleural effusions. Respirology, 15: 115–118. doi: 10.1111/j.1440-1843.2009.01663.x

Author Information

  1. 1

    Department of Thoracic Surgery of Hospital Aristides Maltez, Salvador, BA, and

  2. 2

    Division of Thoracic Surgery, Hospital das Clinicas, University of São Paulo Medical School, São Paulo, SP, Brazil

*Ricardo Mingarini Terra, Al. Fernão Cardim, 161, ap. 61, Sao Paulo, SP CEP 01403-020, Brazil. Email: rmterra@uol.com.br

Publication History

  1. Issue published online: 27 DEC 2009
  2. Article first published online: 23 NOV 2009
  3. Received 18 May 2009; invited to revise 29 June 2009, 25 July 2009; revised 13 July 2009, 26 July 2009; accepted 27 July 2009 (Associate Editor: Jose Porcel).

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Keywords:

  • efficacy;
  • iodopovidone;
  • malignant pleural effusion;
  • pleurodesis;
  • safety

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.

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.

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