What is a pleural effusion?
A pleural effusion is a collection of fluid or blood that collects outside of the lung tissue in the chest cavity. Injury, infection, or tumor can cause a pleural effusion. Sometimes it will resolve on its own, as the lung heals. Sometimes it will need to be drained either at the bedside or with surgery. Pleural effusions can be accompanied by shortness of breath and or chest pain.
How are pleural effusions managed?
The management of a pleural effusion depends on the cause of the effusion, the duration that it has been there, it’s impact on breathing, and the likelihood of recurrence. If there is a reversible cause, such as heart failure or pneumonia, the effusion may initially be medically managed. As the fluid is reabsorbed from the lung, the lung can re-expand. Sometimes, a tube is placed in the chest wall to help evaluate the fluid, send a sample of fluid for diagnosis, and aid in lung re-expansion. This is called a thoracentesis. If the effusion has been there chronically, either from malnutrition or kidney failure, it may be more difficult to correct, and the lung may not readily re-expand. Tumors of the chest or surgery of the chest can lead to chronic effusions as well, which may require surgical removal of scar and placement of adhesive (pleurodesis) to stick the lung to the chest wall to aid lung expansion. If the lung cannot re-expand because the airflow to this part of the lung is blocked by tumor, then a chronic drain may be placed in the chest wall to keep the pleural effusion volume low and allow for improved breathing.
Can a pleural effusion be a sign of a new medical problem outside of the lungs?
Yes. Pleural effusions can come from many various sources, some of which were mentioned above. Other sources include liver failure, damage to the thoracic duct, pancreatitis, tuberculosis, abdominal cancers, and bleeding.
What tests are commonly done in the evaluation of pleural effusions?
Some common tests for the evaluation of pleural effusion include sputum testing, pleural fluid testing, pulse oximetry and arterial blood oxygen level, echocardiogram, ultrasound of the chest, and CAT scan of the chest.
Self-Check for management of pleural effusion
- I have had appropriate testing done and know the cause of my pleural effusion.
- I know what medications my doctor is using and how they may help decrease the amount of fluid I have collected.
- If my doctor has me on a special diet to help control my pleural effusion, I understand it and am following it.
- If I require a chronic drain for my effusion, I know how to keep it clean and how/when to empty it. I know how to check for signs of infection from the drain.
Managing Doctors
- Primary Care
- Pulmonary
- Thoracic Surgery
- Cardiology
- Nephrology
- Infectious Disease