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Pleural Effusions Notes

Medicine Notes > Respiratory Notes

This is an extract of our Pleural Effusions document, which we sell as part of our Respiratory Notes collection written by the top tier of University Of Leicester students.

The following is a more accessble plain text extract of the PDF sample above, taken from our Respiratory Notes. Due to the challenges of extracting text from PDFs, it will have odd formatting:

Pleural Effusions A collection of fluid in the pleural space If its an infected effusion = empyema If related to pneumonia = "para-pneumonic effusion" Pathogenesis
- Normal parietal pleura produces fluid that is reabsorbed by visceral pleura. Can be disrupted by; o Excessive fluid production (inflammation) o Impaired re-absorption
= Accumulation of fluid Clinical features
- Dyspnoea (must be moderate to cause this)
- Pleural pain
- Cough Signs
- Reduced expansion
- Stony dull percussion
- Reduced breath sounds and vocal resonance
- Bronchial breathing above effusion
- CXR = blunting of costophrenic angles in small effusions Investigations
- Exudate vs transudate to elicit cause of effusion o If pH of fluid is <7.2 = parapneumonic effusion or empyema that will only resolve with drainage o Fluid should also be sent for
? Biochemistry (Lactate dehydrogenase - high in rheumatoid effusions and exudates and protein estimation)
? Microbiology (culture and cytology) Management
- Treatment of underlying condition (particularly transudates)
- Therapeutic large volume aspiration
- Chest drain
- In malignanct or other recurrent effusions, agent (tetreacycline, bleomycin) can be introduced to cause the two layers of the pleura to stick together and prevent reaccumulation
- Pleurodesis

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