Efficacy and safety of iodopovidone pleurodesis through chest tube in spontaneous pneumothorax.

UNLABELLED: Pleurodesis is one of the best methods of controlling malignant pleural effusions and pneumothorax. Recently Iodopovidone (IP) which is cheap and easily available was used for pleurodesis and demonstrated low morbidity with good results similar to talcum powder. However, in those studies a wide range of pleural diseases were included, and heterogeneity makes it difficult to draw conclusions about spontaneous pneumothorax (SP). The aim of this study was to evaluate the efficacy and safety of IP pleurodesis in SP.

METHODS

In 29 patients, we instilled 20 ml IP 10% diluted with 80 ml of normal saline through a chest tube, clamped for 4 h. Data on adverse events including chest pain, respiratory distress, allergic reactions, hypotension and failure of PD (the requirement for additional pleural procedures and recurrence) were collected. The follow-up period was 3 to 21 months.

RESULTS

Complete response with no recurrence was obtained in 27 (93% percent) patients. One patient with bone marrow transplantation with cystic lung changes in lungs returned two months later with bilateral pneumothoraces. A case of Wegener's granulomatosis on corticosteroids and immunosuppressive therapy returned with SP on the same side four months later. Five (13%) patients experienced chest pain with visual scale measurment 1 to 5. No hypotension, allergic reaction, visual impairment were observed.

CONCLUSIONS

Pleurodesis with IP was successful and was associated with only minor complication. It appears to be a good option for the pleurodesis in SP.