[Causes of resistant pleural effusions and efficiency of chemical pleurodesis in these patients].

Abstract

OBJECTIVE:

To study the causes of resistant pleural effusions and efficiency of chemical pleurodesis with Betadin, Iodopyrone and concentrated glucose solution in these patients.

MATERIAL AND METHODS:

Resistant pleuritis with daily exudation over 300 ml lasting ≥6 days occurred in 206 (48%) out of 424 cases of pleural effusions. Twenty-seven patients underwent chemical pleurodesis with Betadine, 15 patients - mixture of Iodopyrone with concentrated glucose solution. Solutions were injected via pleural drainage.

RESULTS:

In multivariate analysis, the risk factors of complicated pleuritis were air leakage, prolonged drainage period, age over 60 years, fluid output volume during thoracoscopy and higher Charlson index. Pleurodesis with a mixture of Betadine 10% 10 ml and glucose 40% 40 ml suppressed exudation in 92.6% of cases. Pleurodesis with a mixture of Iodopyron and glucose solution in the same quantities was effective in 93.4% of cases. If exudation continued, pleurodesis was repeated after 3 days. VAS score of pain syndrome following Iodopyrone injection was 3.0±1.8, in case of Betadine - 3.4±0.3. No significant hemodynamic changes were noted. In case of malignant pleural effusions and low functional parameters after fluid evacuation, favorable effect was obtained after pleurodesis with a mixture of povidone-iodine with glucose through the same catheter and subsequent removal of drainage tube.

CONCLUSION:

Resistant pleural effusions with daily exudation over 300 ml for more than 6 days are characterized by advanced risk of infectious and inflammatory complications due to air leakage and duration of drainage. Pleurodesis with mixtures of Betadine or iodopyrone and 40% glucose solution is effective for resistant pleural effusions.

• Authors: S A Plaksin, L I Farshatova
• Journal: Khirurgiia (Khirurgiia (Mosk)) Issue 7 Pg. 24-30 ( 2021) ISSN: 0023-1207 [Print] Russia (Federation)
• Vernacular Title: Prichiny rezistentnykh plevral'nykh vypotov i effektivnost' khimicheskogo plevrodeza v ikh lechenii.
• PMID: 34270190 (Publication Type: Journal Article)

Topics

• Humans
• Middle Aged
• Pleural Effusion (etiology, therapy)
• Pleural Effusion, Malignant
• Pleurisy (diagnosis, etiology, therapy)
• Pleurodesis
• Thoracoscopy