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Lung injury induced by the pulmonary instillation of povidone-iodine in rats

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Abstract

Purpose

Povidone-iodine (polyvinylpyrrolidone iodine, PI), which is commonly used as a pre- and postoperative oral antiseptic, has been reported to cause pneumonia secondary to its pulmonary aspiration. Because no studies have yet investigated the underlying mechanisms of PI-induced pneumonia, we conducted an animal study to analyze the effect of PI on the lung following its pulmonary instillation.

Methods

The lungs of 61 male Sprague–Dawley rats (150–250 g) were instilled with varying volumes of either phosphate-buffered saline or PI solutions varying in strength from 0.01% to 10%. The lungs were harvested from the rats 1 h or 1, 3, 5, 7, 14, or 21 days after instillation for radiologic examination, macroscopic and light and scanning electron microscopic assessment, and an assessment of pulmonary toxicity using an MTT-based cytotoxicity assay.

Results

Macroscopically, atelectasis was the primary pulmonary lesion after PI instillation. The primary light and scanning electron microscopic findings were an initial inflammatory phase with edema, alveolar rupture, and leukocyte infiltration into the pulmonary interstitium, which progressed into a phase of lung parenchyma loss, and then resolved itself with scar tissue formation. Lung tissue viability following 1-day exposure to 0.01%, 0.1%, 1%, or 5% PI progressively decreased in a significant dose-dependent manner.

Conclusions

PI aspiration can cause lung injury, including pulmonary fibrosis.

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References

  1. Durani P, Leaper D. Povidone-iodine: use in hand disinfection, skin preparation and antiseptic irrigation. Int Wound J. 2008;5:376–87.

    Article  PubMed  Google Scholar 

  2. Sauerbrei A, Wutzler P. Virucidal efficacy of povidone-iodine-containing disinfectants. Lett Appl Microbiol. 2010;51:158–63.

    CAS  PubMed  Google Scholar 

  3. Rahn R. Review presentation on povidone-iodine antisepsis in the oral cavity. Postgrad Med J. 1993;69:S4–9.

    Article  PubMed  Google Scholar 

  4. Ogata J, Minami K, Miyamoto H, Horishita T, Ogawa M, Sata T, Taniguchi H. Gargling with povidone-iodine reduces the transport of bacteria during oral intubation. Can J Anesth. 2004;51:932–6.

    Article  PubMed  Google Scholar 

  5. Seguin P, Tanguy M, Laviolle B, Tirel O, Mallédant Y. Effect of oropharyngeal decontamination by povidone-iodine on ventilator-associated pneumonia in patients with head trauma. Crit Care Med. 2006;34:1514–9.

    Article  PubMed  Google Scholar 

  6. Masaki H, Nagatake T, Asoh N, Yoshimine H, Watanabe K, Watanabe H, Oishi K, Rikitomi N, Matsumoto K. Significant reduction of nosocomial pneumonia after introduction of disinfection of upper airways using povidone-iodine in geriatric wards. Dermatology. 2006;212:98–102.

    Article  CAS  PubMed  Google Scholar 

  7. Shiraishi T, Nakagawa Y. Evaluation of the bactericidal activity of povidone-iodine and commercially available gargle preparations. Dermatology. 2002;204:37–41.

    Article  CAS  PubMed  Google Scholar 

  8. Howe DJ. Aspiration pneumonia from povidone-iodine (Betadine): report of case. J Oral Surg. 1981;39:224–5.

    CAS  PubMed  Google Scholar 

  9. Numazawa R, Morimoto Y, Yokota S, Yamamura T, Kemmotsu O. Pneumonia due to aspiration of povidone-iodine during anesthesia: a case report. Masui. 1992;41:846–9.

    CAS  PubMed  Google Scholar 

  10. Cheong SH, Lee KM, Yang YI, Seo JY, Choi MY, Yoon YC. Blind oral endotracheal intubation of rats using a ventilator to verify correct placement. Lab Anim. 2010;44:278–80.

    Article  CAS  PubMed  Google Scholar 

  11. Cheong SH, Lee JH, Lee KM, Cho KR, Yang YI, Seo JY, Yoon SY, Lee JN, Choi MY, Lee SE, Kim YH, Lim SH. The effects of hemodilution on acute inflammatory responses in a bleomycin-induced lung injury model. Exp Lung Res. 2009;35:841–57.

    Article  CAS  PubMed  Google Scholar 

  12. Cheong SH, Yang YI, Seo JY, Jun DH, Ko MJ, Cho KR, Lee SE, Kim YH, Lim SH, Lee JH, Lee KM. Unilateral administration of a drug into the lung of a small animal. Korean J Anesthesiol. 2010;58:283–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Muller G, Kramer A. Biocompatibility index of antiseptic agents by parallel assessment of antimicrobial activity and cellular cytotoxicity. J Antimicrob Chemother. 2008;61:1281–7.

    Article  PubMed  Google Scholar 

  14. Zamora JL. Chemical and microbiologic characteristics and toxicity of povidone-iodine solutions. Am J Surg. 1986;151:400–6.

    Article  CAS  PubMed  Google Scholar 

  15. Gottardi W. Iodine and iodine compounds. In: Block SS, editor. Disinfection, sterilization and preservation. Philadelphia: Lea & Febiger; 1991. p. 152–66.

    Google Scholar 

  16. Nagatake T, Ahmed K, Oishi K. Prevention of respiratory infections by povidone-iodine gargle. Dermatology. 2002;204:32–6.

    Article  CAS  PubMed  Google Scholar 

  17. Wutzler P, Sauerbrei A, Klöcking R, Brögmann B, Reimer K. Virucidal activity and cytotoxicity of the liposomal formulation of povidone-iodine. Antiviral Res. 2002;54:89–97.

    Article  CAS  PubMed  Google Scholar 

  18. Iwasaki N, Kamoi K, Bae RD, Tsutsui T. Cytotoxicity of povidone-iodine on cultured mammalian cells. Nippon Shishubyo Gakkai Kaishi. 1989;31:836–42.

    Article  CAS  PubMed  Google Scholar 

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Conflict of interest

The authors report no declarations of conflict of interest.

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Authors and Affiliations

  1. Department of Anesthesiology, Paik Hospital, Inje University, Gaegumdong, Jingu, Busan, Korea

    Soon Ho Cheong, Myoung Hun Kim, Kwang Rae Cho, Se Hun Lim, Jeong Han Lee, Kun Moo Lee & Sung Ho Moon

  2. Department of Pathology, Paik Hospital, Inje University, Gaegumdong, Jingu, Busan, Korea

    Young Il Yang

  3. Paik Institute for Clinical Research, Inje University, Gaegumdong, Jingu, Busan, Korea

    Soon Ho Cheong, Young Il Yang & Min Young Choi

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  1. Soon Ho Cheong
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  2. Young Il Yang
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  3. Min Young Choi
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  4. Myoung Hun Kim
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  5. Kwang Rae Cho
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  6. Se Hun Lim
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  7. Jeong Han Lee
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  8. Kun Moo Lee
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  9. Sung Ho Moon
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Correspondence to Soon Ho Cheong.

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Cheong, S.H., Yang, Y.I., Choi, M.Y. et al. Lung injury induced by the pulmonary instillation of povidone-iodine in rats. J Anesth 26, 70–79 (2012). https://doi.org/10.1007/s00540-011-1242-0

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  • DOI: https://doi.org/10.1007/s00540-011-1242-0

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