pulmonary embolism and infarction - pleural effusions in pulmonary embolismĭifferential white cell count of the pleural aspirate is also important, resulting in pleural effusions with mainly granulocytes, eosinophils or lymphocytes 14. It occurs due to the increase in permeability of the microcirculation or alteration in the pleural space drainage to lymph nodes. post coronary artery bypass grafting: small unilateral left-sided pleural effusion can be common 11. It occurs when there is an increase in hydrostatic pressure or a decrease of capillary oncotic pressure. This categorization relies upon the biochemical analysis of aspirated pleural fluid 5: There are many causes of pleural effusion that are broadly split into transudates and exudates. Any process which results in more fluid forming than can be absorbed will produce a pleural effusion. Physiologically, the pleural cavities normally contain approximately 15 mL of serous pleural fluid 6. In fact, depending on the respiratory reserve of the patient, even large amounts of fluid can accumulate within the pleural space before any symptoms are recognized.Įventually as the volume of fluid increases, with resulting passive (relaxation) atelectasis of the adjacent lung, the patient will experience reduced exercise tolerance and breathlessness. Clinical presentationĪ small amount of fluid is completely asymptomatic. However, it is probably safe to say that as congestive cardiac failure and malignancy are some of the most common causes, older patients would be over-represented. These are discussed separately:Īs the accumulation of fluid in the pleural space occurs in a broad range of disparate clinical scenarios, no single demographic is affected rather the epidemiology will match that of the underlying condition. This is important because these effusions may be managed distinctly. If additional corroborative evidence is available, certain (mostly non-transudative) effusions are preferentially designated using more specific terminology. If simple fluid, then the term hydrothorax may be employed, although this is rarely used (other than in combination terms e.g. 
Given that most effusions are detected by x-ray, which generally cannot distinguish between fluid types, the fluid in question maybe simple (transudative) fluid, blood, pus, chylous fluid, etc. The lack of specificity is mainly due to the limitations of the imaging modality. "Pleural effusion" is commonly used as a catch-all term to describe any abnormal accumulation of fluid in the pleural cavity.
0 kommentar(er)
