Pleural effusion Flashcards
reexpansion pulmonary edema pathophysiology?
inc pulmonary blood flow and capillary failure in ipsilateral side->cytokine inflamation on ipsi and contralateral side
treatment of complicated pleural effusion?
thoracostomy with instillation of TPA gyrase
findings of a pleural effusion from a ruptured esophagus?
exudative, low pH, and a high amylase
things that cause a transudative effusion?
cirrhosis, CHF, nephrotic syndrome, iatrogenic infusion of crytalloids into pleural space, urinothorax
defining characteristic of urinothorax?
pleural/serum Cr >1
best test for evaluation pleural effusion?
CT equivalent to US
physiology of effusion?
pleural fluid arises from parietal pleura vasculature and then is reabsorbed by the lymphatics
Lights critera?
pleural/serum: protein >.5, LDH >.6
pseudoexudate in pleural effusion?
due to diuretic use, can account for albumin (serum albumin- pleural albumin) if <1.2
bloody pleural fluid?
TB malignancy
milky pleural fluid?
chylous
anchovy paste pleural fluid?
ameoba
high triglycerides in pleural fluid?
chylothorax
high Cr in pleural fluid?
urinothorax
Post CABG pleural effusion?
L>R, exudate,
TB pleural fluid?
exudate, lymphocyte predominance, positive ADA, culture negative
drugs that cause an exudative effusion?
nitrofurantoin, methotrexate, amiodarone, phenytoin
exudate with increased amylase?
ruptured pancreatic pseudocyst
chylothorax?
milky with triglycerides >11
treatment for a retaine dhemothorax?
VATS
when to do thoracotomy for hemothorax?
> 200 cc/hr, or 1500 in 24 hour
TPA plus dornase benefit for empyema?
reduce need for surgery and decrease LOS
pleural fluid salivary isoamylase effusion cause?
boerhaave
pancreatic isoamylase in fluid?
pseudocyst
