Kasdallah Nadia, Kbaier Hakima, Ben Salem Hatem, Blibech Sonia, Bouziri Asma, Douagi Mohamed
Tunis Med. 2016 Dec;94(12):834.
Povidone iodine (PVI) pleurodesis is commonly used in adult. However, this procedure is still nonconsensual in newborns.
This article aimed to report a new case of refractory congenital chylothorax (CCT) managed with PVI pleurodesis with a review of previousreported cases.
a systematic review of similar cases published in PubMed. Clinical patterns, therapeutic modalities and outcome variables werereported.
In a full term neonate presenting refractory CCT, PVI pleurodesis was performed at day 16 of life by one intrapleural instillation of PVI4% with rapid success and no side effects. Renal function and thyroid tests stilled normal before and after instillation. The analysis of 18 casesreported in Medeline and our observation provided the following data: this procedure was successful without side effects in 11/19 cases. Severeside effects were reported in four patients with high risks before procedure.
PVI pleurodesis seems to be effective and inoffensive in the management of refractory CCT. It may be a good alternative tosurgery. Nevertheless, randomized studies on large neonatal population are required to precise: the risks and benefits of this procedure, thetiming and the modalities of its realization (duration of intervention, dilution and dosage of PVI) according to the patient`s field (gestational age,weight and associated morbidity).
聚维酮碘（PVI）胸膜固定术常用于成人。然而，该手术在新生儿中仍未达成共识。
本文旨在报告一例采用PVI胸膜固定术治疗难治性先天性乳糜胸（CCT）的新病例，并回顾先前报道的病例。
对发表在PubMed上的类似病例进行系统回顾。报告临床模式、治疗方式和结果变量。
在一名足月新生儿出现难治性CCT时，在出生后第16天通过一次胸腔内注入4%的PVI进行胸膜固定术，迅速成功且无副作用。注入前后肾功能和甲状腺检查仍正常。对Medeline报道的18例病例和我们的观察分析提供了以下数据：该手术在11/19例中成功且无副作用。4例术前高危患者报告有严重副作用。
PVI胸膜固定术在难治性CCT的治疗中似乎有效且无害。它可能是手术的一个很好的替代方法。然而，需要对大量新生儿人群进行随机研究，以明确：该手术的风险和益处、根据患者情况（胎龄、体重和相关发病率）实施的时机和方式（干预持续时间、PVI的稀释和剂量）。
