Success of Using Iodopovidone as a Sclerosing Agent for Chemical Pleurodesis in a Tertiary Care Center: A Descriptive
Deebya Raj Mishra1, Narendra Bhatta1, Puru Koirala2
1Department of Pulmonary, Critical Care and Sleep Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Introduction:
Pleurodesis is a procedure to achieve symphysis between the two layers of pleura aimed at preventing the accumulation of either air or fluid in the pleural space. In Nepal, intrapleural instillation of the chemical sclerosing agent is more commonly done as thoracoscopy facility is not easily available. However, iodopovidone is rarely used for this purpose in Nepal. The study aims to find the prevalence of success using iodopovidone as the chemical sclerosing agent.
Methods:
The study included cases undergoing pleurodesis over a two-year period. The clinicodemographic data, diagnosis, treatment effect and treatment response were analyzed. The treatment response was graded as Treatment Success (Complete Response or Partial Response) and Treatment Failure.
Results:
Pleurodesis was done in a total of 54 cases. Of those, 39 cases were Secondary Spontaneous Pneumothorax, 11 were Malignant Pleural Effusion, 3 were Primary Spontaneous Pneumothorax, and 1 was a case of Hepatic Hydrothorax. Among Secondary Spontaneous Pneumothorax, Pleurodesis was successful in 37 (95%) out of 39 cases, with 35 (90%) having a Complete Response and 2 (5%) having a Partial Response while 2 (5%) had Treatment failure. Among Malignant Pleural Effusion, treatment success was achieved in 6 (55%) out of 11, whereas 5 (45%) failed the treatment. The commonest complication was burning sensation, and the commonest pain scale was "distressing."
Conclusions:
This study highlights the safety and ease of use of iodopovidone as an agent for chemical pleurodesis. It confirms the high rate of success of pleurodesis in cases of pneumothorax as found in other studies. In contrast, the success rate is understandably lower in cases of Malignant Pleural effusion.
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