Numazawa R, Morimoto Y, Yokota S, Yamamura T, Kemmotsu O
Department of Anesthesiology, Hokkaido University School of Medicine, Sapporo.
Masui. 1992 May;41(5):846-9.
We report a case of pneumonia secondary to aspiration of povidone-iodine, which was used as an oral antiseptic. The patient was 17 y.o. female (body weight: 70 kg) who underwent a transsphenoidal resection of pituitary adenoma. Although she had a history of asthma during her childhood, no asthmatic attacks occurred for the past 10 yrs. After satisfactory anesthesia induction and tracheal intubation, 60 ml of 0.7% povidone-iodine solution was used to clean the oral cavity by a surgeon. Insufficient sealing by the cuff occurred after suturing the tube, which had made a needle hole in the cuff. Arterial oxygen saturation dropped to 90% and an increased resistance in the lungs was noted. The trachea was reintubated and she was transferred to the ICU. Her chest X-ray revealed signs of pneumonia and atelectasis in the right upper lobe. Mechanical ventilation with PEEP and periodical bronchial toilet were performed during her stay in the ICU for 42 hrs. A week was needed for the improvement of her X-ray findings. Although povidone-iodine is thought to be safe and affective antiseptics, severe complications from its aspiration may occur in patients whose airways are sensitive as observed in this case.
我们报告一例因吸入用作口腔消毒剂的聚维酮碘继发肺炎的病例。患者为17岁女性（体重70kg），接受了垂体腺瘤经蝶窦切除术。尽管她童年时有哮喘病史，但过去10年未发生哮喘发作。在满意的麻醉诱导和气管插管后，外科医生用60ml 0.7%聚维酮碘溶液清洁口腔。缝合气管插管后，插管套囊密封不足，套囊上有一个针孔。动脉血氧饱和度降至90%，并注意到肺部阻力增加。重新进行气管插管，并将她转入重症监护病房（ICU）。她的胸部X线显示右上叶有肺炎和肺不张迹象。在她入住ICU的42小时期间，进行了呼气末正压通气（PEEP）机械通气和定期支气管灌洗。胸部X线表现改善需要一周时间。尽管聚维酮碘被认为是安全有效的消毒剂，但如本病例所示，在气道敏感的患者中，吸入聚维酮碘可能会发生严重并发症。
