2-42
2-42. PLEURAL EFFUSION
a. Pleural effusion is the collection of fluid in the pleural space. Normally, the pleural space contains a small amount of lubricating fluid that allows the surfaces of the visceral and parietal pleura to move without friction. When pleural effusion is present, the patient will experience shortness of breath and rapid pulse. Decreased breath sounds will be noted on auscultation of the affected lung.
(1) Pleural effusion is normally secondary to other disease processes. When factors influencing formation and re-absorption of pleural fluid are altered, a transudate occurs. A
transudate is fluid with a relatively low content of protein, cells, and cellular debris. The presence of transudate would indicate an underlying cause such as congestive heart failure, renal failure, or ascites.
(2) Local inflammation within the pleura, in adjacent tissues, or beneath the diaphragm will cause an exudate. An exudate is fluid characterized by a relatively high content of protein, cells, and cellular debris. The presence of exudate is indicative of tuberculosis, pneumonia, pulmonary viruses, or cancer.
b. Again, the physician must identify and treat the underlying cause in order for the effusion to resolve. Large amounts of fluid should be removed in order to relieve the dyspnea and discomfort felt by the patient. This can be done by needle aspiration (thoracentesis) or by the insertion of chest tubes to drainage. Analgesics should be used to reduce discomfort.
