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PLEURAL EFFUSION PowerPoint Presentation

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Description : quick review of PLEURAL EFFUSION. Pleural effusions can be transudates or exudates.

Tags : PLEURAL EFFUSION,Causes of transudates pleural effusion,Chylous pleural effusions

Published on : Feb 01, 2022 | Views : 2264 | Downloads : 9

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Slide 1-

Pleural effusion Danial dehghan Supervisor: Dr. ghaem panah
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etiology Fluid accumulates in the pleural space when the local hydrostatic forces that are pushing fluid out of the vascular space exceed the oncotic forces that are drawing fluid back into the vascular space. Pleural effusions can be transudates or exudates.
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etiology Causes of transudates pleural effusion: congestive heart failure hypoproteinemia states Causes of exudates pleural effusion: Almost any pulmonary inflammatory process can result in pleural fluid accumulation infection (e.g., tuberculosis, bacterial pneumonia) collagen vascular diseases (e.g., systemic lupus erythematosus) malignancy
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etiology Chylous pleural effusions (elevated triglyceride levels) are seen with thoracic duct injury and abnormalities of lymphatic drainage (lymphangiomyomatosis, lymphangiectasia).
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parapneumonic effusion Bacterial pneumonia can lead to an accumulation of pleural fluid (parapneumonic effusion). When this fluid is purulent or infected, then it is called an empyema. Parapneumonic effusion/empyema is the most common reason for effusion in children. Most parapneumonic effusions are due to pneumonia caused by Streptococcus pneumoniae, group A streptococci, or Staphylococcus aureus.
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Clinical Manifestations Small pleural effusions may be asymptomatic. If they are large enough to compress lung tissue, then they can cause: Dyspnea Tachypnea Occasionally chest pain Effusions due to infection are usually associated with fever, malaise, poor appetite, pleuritic chest pain, and splinting.
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Clinical Manifestations Physical findings: tachypnea decreased breath sounds dullness to percussion decreased tactile fremitus Large effusions may occupy more than half the hemithorax and cause a mediastinal shift away from the affected side, compromising respiratory status, particularly in young children.
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Diagnostic Studies Chest radiography Chest ultrasonography Chest CT scan Analysis of pleural fluid
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Analysis of pleural fluid
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Analysis of pleural fluid Routine tests on pleural fluid such as cell count, pH, protein, lactose dehydrogenase, and glucose characterize the effusions. Triglyceride levels, cytology, hematocrit, gram and acid-fast bacilli stain, culture, and adenosine deaminase levels can be useful in diagnosing chylous, malignant, and tuberculous effusions.
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Treatment Therapy is directed at the underlying condition causing the effusion and at relief of the mechanical consequences of the fluid collection. For small effusions, especially if they are transudates, no pleural drainage is required. Large effusions that are causing respiratory compromise should be drained. With parapneumonic effusions/empyema, a chest tube alone is often not sufficient because the fluid may be thick and loculated. In such cases, pleural drainage is best achieved with either the administration of fibrinolytic agents via chest tubes or VATS.