Chemical pleurodesis with povidone-iodine (Betadine) in congenital chylothorax: personal experience and review of literature
Abstract
Congenital chylothorax is a serious neonatal condition with high mortality and difficult management. Chemical pleurodesis can limit the need for surgical treatment, but there is no consensus on the optimal chemical agent for the lack of solid evidence.
We report our experience with povidone-iodine (PVI) chemical pleurodesis in two neonates with congenital chylothorax. Pleurodesis consisted in the injection of 2 ml/kg of a 4% povidone iodine solution inside the pleural space, leaving the pleural tube clamped for the subsequent 4 hours.
In both cases, repeated doses of povidone-iodine were required to completely stop chyle formation. Based on our experience, chemical pleurodesis with povidone-iodine promptly and definitely stopped pleural effusion, with no side effect observed.
Since its first use in 2003, we provide analysis of all published neonatal case reports concerning PVI chemical pleurodesis in congenital chylothorax (nv=20), with both success and survival rate at 80%.