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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 cavity, or pleural space (or sometimes intrapleural space), is the potential space between the pleurae of the pleural sac that surrounds each lung. A small amount of serous pleural fluid is maintained in the pleural cavity to enable lubrication between the membranes , and also to create a pressure gradient .
With pleural effusion, fluid often builds up in the costophrenic angle (due to gravity). This can push the lung upwards, resulting in "blunting" of the costophrenic angle. The posterior angle is the deepest. Obtuse angulation is sign of disease. Chest x-ray is the first test done to confirm an excess of pleural fluid.
Pleural effusion obliterates the pleural vacuum and can collapse the lung (due to hydrostatic pressure), impairing ventilation and leading to type 2 respiratory failure. The condition can be treated by mechanically removing the fluid via thoracocentesis (also known as a "pleural tap") with a pigtail catheter , a chest tube , or a thoracoscopic ...
If the pleural fluid is infected, treatment involves antibiotics and draining the fluid. If the infection is tuberculosis or from a fungus, treatment involves long-term use of antibiotics or antifungal medicines. If the fluid is caused by tumors of the pleura, it may build up again quickly after it is drained.
Data from a meta-analysis has shown that a pleural fluid pH of <7.2 is the most powerful indicator to predict the need for chest tube drainage in patients with non-purulent, culture negative fluid. [ 16 ]
Pleural effusions may also develop following the accumulation of other fluids within the pleural cavity; if the fluid is blood it is known as hemothorax (as in major chest injuries), if the fluid is pus it is known as pyothorax (resulting from chest infections), and if the fluid is lymph it is known as chylothorax (resulting from rupture of the ...
Pleural effusion and empyema - Microorganisms from the lung may trigger fluid collection in the pleural cavity, or empyema. Pleural fluid, if present, should be collected with a needle and examined. Depending on the results, complete drainage of the fluid with a chest tube may be necessary to prevent proliferation of the infection. Antibiotics ...