EFFICACY OF POVIDONE-IODINE AS A PLEURODESIS AGENT IN PATIENTS WITH MALIGNANT PLEURAL EFFUSION

Abstract

Background: Malignant pleural effusion (MPE) is a common complication of advanced malignancies, significantly affecting patient quality of life.  Objective: To evaluate the efficacy and safety of povidone-iodine as a pleurodesis agent in patients with malignant pleural effusion.

Methods: This descriptive case series was conducted at the Department of Pulmonology, Mayo Hospital, Lahore from 20 December 2024 to 2 June 2025. A total of 64 patients with cytologically or histologically confirmed MPE underwent chemical pleurodesis using 10% povidone-iodine. A chest tube was inserted to drain the effusion, followed by instillation of a mixture of povidone-iodine, lidocaine, and normal saline.

 Results: Out of 64 patients, 50 (78.1%) achieved complete response, 9 (14.1%) had partial response, and 5 (7.8%) experienced treatment failure. Minor complications included chest pain (29.7%), fever (10.9%), and nausea (6.3%). No major adverse events were reported. Treatment efficacy was not significantly associated with age, gender, primary malignancy type, or comorbidities. Conclusion: Povidone-iodine demonstrated high efficacy and safety as a pleurodesis agent in patients with malignant pleural effusion. It offers a cost-effective, accessible, and well-tolerated alternative to talc, especially suitable for use in low-resource settings.