Iodopovidone pleurodesis in the treatment of refractory pleural effusions

Background: In this study, we assessed the efficacy of iodopovidone pleurodesis in patients with refractory pleural effusions. Methods: Between March 2009 and April 2012, 43 patients (34 males, 9 females; mean age 65.6 +/- 9.8 years; range 37 to 79 years) received iodopovidone pleurodesis was for the treatment of refractory pleural effusion. Pleural effusion was due to malignancy in 31 and heart failure in 12 patients. Iodopovidone (20 mL 10% plus 80 mL 0.9% NaCl) was delivered through the chest tube. The chest tube was not clamped and raised 60 cm above the chest level. The tube was removed when the amount of drainage reduced to 50 mL/day. Results: In patients with malignant pleural effusion, iodopovidone irrigation produced significant decrease in daily pleural drainage from 574.9 +/- 169.0 mL to 71.7 +/- 25.9 mL (p=0.000), and in patients with heart failure daily drainage decreased from 588.9 +/- 138.4 mL to 63.5 +/- 12.5 mL which was also significant (p<0.001). No clinical side effect related to the procedure was observed. Conclusion: Iodopovidone was shown to be effective in patients with refractory pleural effusions. The use of this agent without clamping the chest tube is safe, inexpensive and effective.