Povidone-iodine pleurodesis versus talc pleurodesis in preventing recurrence of malignant pleural effusion

Abstract

BackgroundMalignant pleural effusions continue to be a common problem in patients with metastatic disease, leading to a significant reduction in quality of life with progressive dyspnea, dry cough, chest pain and reduced physical activity. This study was conducted to compare the efficacy, safety, and outcome of Talc Powder Pleurodesis (TPP) with Povidone-iodine Pleurodesis (PIP) through a chest drain as a palliative preventive treatment of recurrent malignant pleural effusion.MethodsA total of 39 neoplastic patients with recurrent malignant pleural effusion were enrolled in a prospective randomized trial. Twenty-one patients received Talc pleurodesis (group A), and eighteen patients (group B) received Povidone-iodine pleurodesis. The continuous variables were expressed as mean values ± standard deviation (SD) and compared using the unpaired t-test. The discrete variables were expressed as percentage and compared using the chi-square test (χ2) test. p-values of less than 0.05 were considered significant.ResultsOur study included 11 males and 28 females, the mean age was (71.0 ± 5.0) years for group A and (70.9 ± 5.1) years for group B (non-significant). Post-procedure analgesic requirements were recorded in both groups. Four patients in each group had fever (>38°C) within 48 hours of the procedure. Both groups achieved good symptomatic relief. There were no in-hospital deaths. The mean post-procedure hospital stay was (4.7 ± 1.2) days for group A and (4.2 ± 1.0) for group B (non-significant). At follow-up recurrence of significant pleural effusion requiring intervention was noted in four and five patients in group A and group B, respectively (non-significant difference).ConclusionPovidone-iodine pleurodesis can be considered as a good alternative to Talc pleurodesis for recurrent malignant pleural effusion. The drug is available, cost effective, safe and can be administered through an intercostal drain and repeated if necessary.

Old age and underlying interstitial abnormalities are risk factors for development of ARDS after pleurodesis using limited amount of large particle size talc

“…However, development of ARDS after pleurodesis with limited amount of large particle size talc is a rare complication, and reporting only four patients does not diminish its importance. In addition, the incidence of ARDS in this population was much higher than those of previous studies . The high prevalence of underlying interstitial lung abnormalities (4/27, 11%) may contribute to this high incidence.…”

“…In addition, the incidence of ARDS in this population was much higher than those of previous studies. 7,27,28 The high prevalence of underlying interstitial lung abnormalities (4/27, 11%) may contribute to this high incidence. Three of the four patients with interstitial lung abnormalities indeed developed ARDS after talc pleurodesis.…”

Pigtail Catheter: A Less Invasive Option for Pleural Drainage in Egyptian Patients with Recurrent Hepatic Hydrothorax

“…Pleurodesis was performed using povidone-iodine, which is an effective, inexpensive, safe, and feasible agent for chemical pleurodesis previously used in the management of malignant pleural effusion [ 14 , 15 ]. Among our 60 patients having pigtail catheter, pleurodesis was performed on 38 patients with no recurrence of fluid within three months.…”

Does sericin pleurodesis increase the basic fibroblastic growth factor and high-sensitive c-reactive protein levels in rat plasma?

“…The studies previously conducted by Yazicioglu et al used 30 mg sericin in rats and obtained successful results, and so we used the same dose of sericin in the present study [3,4]. The administrated dose of talcum powder in adults varied between 4 and 5 grams in previous studies, and so a dose of 17 mg was estimated to be appropriate for rats with a mean weight of 250 ± 30 g [9][10][11]. The study previously conducted by Yazicioglu et al did the sacrification of rats 12 days later, and so we sacrificed them on the same day [4].…”