Pleurodesis is performed to prevent recurrence of
spontaneous pneumothorax or
pleural effusion, and can be done chemically or mechanically. It is generally avoided in patients with
cystic fibrosis if possible, because
lung transplantation becomes more difficult following this procedure. Previous pneumothorax with or without pleurodesis is not a contraindication to subsequent lung transplantation.
Chemical Chemicals such as
bleomycin,
tetracycline (e.g.,
minocycline), Pharmacy-prepared chemicals for pleurodesis should be clearly labeled "NOT FOR IV ADMINISTRATION" to avoid potentially fatal wrong-site medication errors.
Sterile talc powder, administered intrapleurally via a
chest tube, is indicated as a
sclerosing agent to decrease the recurrence of malignant pleural effusions in symptomatic patients. It is usually performed at the time of a diagnostic thoracoscopy.
Povidone iodine is equally effective and safe as talc, and may be preferred because of easy availability and low cost. Alternatively, tunneled pleural catheters (TPCs) may be placed in an outpatient setting and often result in auto-pleurodesis, whereby portable vacuum bottles are used to evacuate the pleural fluid. Routine evacuation keeps the pleura together, resulting in physical agitation by the catheter, which slowly causes the pleura to scar together. This method, though the minimally invasive and minimal cost solution, takes an average of about 30 days to achieve pleurodesis and is therefore the slowest means of achieving pleurodesis among other modalities. ==References==