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A pleural effusion is accumulation of excessive fluid in the pleural space, the potential space that surrounds each lung.Under normal conditions, pleural fluid is secreted by the parietal pleural capillaries at a rate of 0.6 millilitre per kilogram weight per hour, and is cleared by lymphatic absorption leaving behind only 5–15 millilitres of fluid, which helps to maintain a functional ...
The pleural fluid is most often straw-colored, and it has a distinct smell like ammonia. The fluid usually has a nucleated cell count between 50 and 1500 per cm 3. [4] The pH of the fluid is usually between 5 and 7. [9] Primary factors for diagnosing urinothorax by pleural fluid include low protein and high lactate dehydrogenase content. [10]
An exudate is defined as pleural fluid to serum total protein ratio of more than 0.5, pleural fluid to serum LDH ratio > 0.6, and absolute pleural fluid LDH > 200 IU or > 2 ⁄ 3 of the normal. An exudate is defined as pleural fluid that filters from the circulatory system into lesions or areas of inflammation.
Fluid in space between the lung and the chest wall is termed a pleural effusion. There needs to be at least 75 mL of pleural fluid in order to blunt the costophrenic angle on the lateral chest radiograph and 200 mL of pleural fluid in order to blunt the costophrenic angle on the posteroanterior chest radiograph. On a lateral decubitus, amounts ...
The most often used "golden" criteria for empyema are pleural effusion with macroscopic presence of pus, a positive Gram stain or culture of pleural fluid, or a pleural fluid pH under 7.2 with normal peripheral blood pH.
Thus, pleural fluid is produced and reabsorbed continuously. The composition and volume is regulated by mesothelial cells in the pleura. [5] In a normal 70 kg human, a few milliliters of pleural fluid is always present within the intrapleural space. [6] Larger quantities of fluid can accumulate in the pleural space only when the rate of ...
If normal thoracic duct drainage is disrupted, either due to obstruction or rupture, chyle can leak and accumulate within the negative-pressured pleural space. In people on a normal diet, this fluid collection can sometimes be identified by its turbid, milky white appearance, since chyle contains emulsified triglycerides.
Chest x-ray is the first test done to confirm an excess of pleural fluid. The lateral upright chest x-ray should be examined when a pleural effusion is suspected. In an upright x-ray, 75 mL of fluid blunts the posterior costophrenic angle. Blunting of the lateral costophrenic angle usually requires about 175 mL but may take as much as 500 mL.