Department of Pulmonary Medicine, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
Indian J Med Res. 2012 Mar;135(3):297-304.
BACKGROUND & OBJECTIVES: Chemical pleurodesis is an accepted therapy for patients with recurrent pleural effusions and pneumothorax. Iodopovidone has been shown to be safe and effective for chemical pleurodesis in several studies. The aim of this systematic review was to update a previously reported meta-analysis on the efficacy and safety of iodopovidone pleurodesis.
Two databases MEDLINE and EMBASE were searched for a period (1952-2010), and studies that have reported success rates with iodopovidone pleurodesis were selected. The proportions with 95 per cent confidence interval (CI) were calculated to assess the outcomes in the individual studies and the results were pooled using a random effects model.
Thirteen eligible studies with 499 patients were included in the mata-analysis. The success rates varied from 70 to 100 per cent in different studies with the pooled success rate being 88.7 per cent (95% CI, 84.1 to 92.1). The success rate was not affected by the method (tube thoracostomy vs. thoracoscopy, 89.6 vs. 94.2%) or the indication of pleurodesis (pleural effusion vs. pneumothorax, 89.2 vs. 94.9%). The only significant complication reported was chest pain of varying degree. Systemic hypotension was reported in six patients across the studies. There were no deaths associated with iodopovidone pleurodesis. Statistical heterogeneity and publication bias were found.
INTERPRETATION & CONCLUSIONS: Iodopovidone may be considered a safe and effective agent for chemical pleurodesis in patients with pleural effusions and recurrent pneumothoraces.
化学性胸膜固定术是治疗复发性胸腔积液和气胸患者的一种公认疗法。几项研究表明，聚维酮碘用于化学性胸膜固定术是安全有效的。本系统评价的目的是更新之前关于聚维酮碘胸膜固定术疗效和安全性的荟萃分析。
检索 MEDLINE 和 EMBASE 两个数据库，检索年限为 1952 年至 2010 年，选择报告了聚维酮碘胸膜固定术成功率的研究。使用 95%置信区间（CI）计算各研究的比例，以评估个体研究的结果，并使用随机效应模型对结果进行汇总。
纳入了 13 项符合条件的研究，共 499 例患者。不同研究中的成功率从 70%到 100%不等，汇总成功率为 88.7%（95%CI，84.1%至 92.1%）。成功率不受方法（胸腔引流管与胸腔镜，89.6%比 94.2%）或胸膜固定术适应证（胸腔积液与气胸，89.2%比 94.9%）的影响。唯一报告的严重并发症是不同程度的胸痛。有 6 例患者在研究中出现全身低血压。没有与聚维酮碘胸膜固定术相关的死亡病例。存在统计学异质性和发表偏倚。
聚维酮碘可被视为治疗胸腔积液和复发性气胸患者化学性胸膜固定术的一种安全有效的药物。
