Pulmonary Effusion - Summary Notes

excess
Pulmonary
fluid in pleural space,
Effusion
Symptoms/Signs:
between visceral and parietal pleura.
Dysqnoea/SOB
-




o
Types:
-



Pleuritic CP

·

Classified on protein concentration of fluid.
-


Reduced Chest expansion
·


Diagnosed through analysis of aspirated pleural fluid. - Stony dull percussion
Reduced Breath Sounds
-




Transudates:protein concentration - 25
g/L.
·
causes:increased venous
pressure (e.g. HF, Constrictive Pericarditis),
or
hypoalbuminaemia (e.g. Cirrhosis, Nephrotic Syndrome).
Exudates:protein concentration 25
g/L.
·
causes:increased permeability capillaries due to
ofpleural infection
le.g. pneumonia, TB, malignancy, Rheumatoid Ar.).

Investigations:
·




·
CXR:
-


Blunted costophrenic angles.
-




opacity from bottom-up.
can be unilateral, unlike oedema.
-




-


mediastinum may be shifted.

·
Fluid aspiration:
-




appearance
-




protein concentration

Culture/Cytology
-




·
Ultrasound
FLUID ASPIRATION ANALYSIS

Management:
·




·
drain in axilla
Chest triangle for symptoms.
Treat
underlying
·
cause.