• Soon Ho Cheong, Kun Moo Lee, Se Hun Lim, Kwang Rae Cho, Young Il Yang, Min Young Choi, and Sung Ho Moon.
• Department of Anesthesiology, Paik Hospital, Inje University, Gaegumdong, Jingu, Busan, Korea. anesjsh@medimail.co.kr
• J Anesth. 2012 Feb 1;26(1):70-9.

PurposePovidone-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.MethodsThe 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.ResultsMacroscopically, 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.ConclusionsPI aspiration can cause lung injury, including pulmonary fibrosis.

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