Podcast #50: Pleural Effusion

Run Time: 4 minuteseffusionhalf

Author: Dr. Peter Bakes

Educational Pearls:

  • 75% of pleural effusions seen in US emergency rooms are caused by one of three non-trauma diagnoses: congestive heart failure, infection, and cancer.
  • First test of choice without history is a diagnostic aspiration of the pleural fluid. This determines if the pleural effusion is transudate or exudate.
  • Transudate is increased hydrostatic pressure causes fluid to leak into pleural space. This fluid would be low in proteins (less than 0.5), including LDH levels. This would be caused by congestive heart failure.
  • Exudate is an inflammatory process causing vessels to leak. This fluid would be rich in proteins (greater than 0.5), including LDH. This would be caused by infection.
  • For treatment, if the effusion is large you would want to take out about 1500 ccs of the fluid. If it is a chronic pleural effusion the patient will receive a chest tube as well as an infusion with a talc slurry. These patients usually have some malignancy causing their pleural effusions.

Link to Podcast: http://medicalminute.madewithopinion.com/pleural-effusion/


References: 
http://www.ncbi.nlm.nih.gov/pubmed/21362716

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3183615/

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