Iodopovidone pleurodesis in the treatment of refractory pleural effusions Refrakter plevral efüzyon tedavisinde iodopovidon plörodezisi

Amac: Bu calismada refrakter plevral efuzyonlu hastalarda iodopovidon plorodezinin etkinligi degerlendirildi. Ca­lis­ma­pla­ni:­Mart 2009 Nisan 2012 tarihleri arasinda refrakter plevral efuzyonlu 43 hastada (34 erkek, 9 kadin; ort. yas 65.6±9.8 yil; dagilim 37-79 yil) iodopovidon plorodez tedavi amaci ile kullanildi. Plevral efuzyon nedeni 31 hastada malignite ve 12 hastada kalp yetmezligi idi. Iodopovidon (20 mL 10%’luk arti 80 mL %0.9 NaCl) gogus tupunden verildi. Tup klempe edilmeksizin gogus seviyesinden 60 cm yukarida tutuldu. Drenaj miktari 50 ml/gune gerilediginde tup cikarildi. Bul gu lar: Iodopovidon irigasyonu ile malign plevral efuzyonlu hastalarda gunluk drenaj miktarinda 574.9±169.0 ml’den 71.7±25.9 mL’ye anlamli bir dusus saglandi (p=0.000), kalp yetmezligi olan hastalarda da gunluk drenaj miktarinda 588.9±138.4 mL’den 63.5±12.5 mL’ye anlamli bir dusus saglandi (p<0.001). Isleme ait hicbir klinik yan etki gozlenmedi. So­nuc:­ Inatci plevral efuzyonu olan hastalarda iodopovidon plorodezinin etkinligi gosterilmistir. Bu ajanin gogus tupunu klemplemeden kullanilmasi guvenli, ucuz ve etkindir. Anah tar soz cuk ler: Iodopovidon; plevra; plevral efuzyon; plorodez; tedavi. 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.