EFFICACY AND SAFETY OF PYODINE-IODINE PLEURODESIS IN MALIGNANT PLEURAL EFFUSION

Abstract

Background: Malignant pleural effusion (MPE) is a common complication of advanced malignancies, leading to significant morbidity due to symptoms such as dyspnea and cough. Chemical pleurodesis is a widely used palliative procedure for managing recurrent MPE. Povidone-iodine, an easily available and cost-effective agent, has been suggested as an alternative sclerosing agent with promising results. Objective: To evaluate the efficacy and safety of povidone-iodine pleurodesis in patients with malignant pleural effusion. Study Design: Descriptive cross-sectional study. Setting: Department of Pulmonology, Saidu Group of Teaching Hospital, Swat, Pakistan. Duration of Study: 02-December-2024 to 02-April-2025. Methods: 157 patients aged between 18 and 65 with confirmed MPE were enrolled. All patients underwent pleurodesis using 20 mL of 10% povidone-iodine mixed with 40 mL normal saline, administered via a 28-French chest tube placed in the sixth intercostal space. Efficacy was assessed by clinical symptom resolution (dyspnea and cough) and radiographic clearance of pleural effusion at six weeks post-procedure. Safety was evaluated by monitoring for adverse events, including fever (≥38.0°C), nausea, and dizziness. Data were analyzed using SPSS version 24, with descriptive statistics reported. Associations were assessed with chi-square tests where appropriate (p-value < 0.05 considered significant). Results: The mean age of patients was 44.81 ± 13.37 years. The overall efficacy rate of pleurodesis was 86.6%. Fever occurred in 22.9% of patients, nausea in 17.8%, and dizziness in 9.6%. Safety was maintained in 84.1% of cases, indicating a favorable tolerance profile. Conclusion: Povidone-iodine pleurodesis demonstrated high efficacy and a favorable safety profile in managing malignant pleural effusions, offering an effective, affordable, and well-tolerated option for palliation with minimal complications.