Pleural effusion Flashcards
Pathophysiology
Fluid in pleural spaces
(blood, pus, exudate, transudate)
Examination findings
Potential trachea deviation
Reduced breath sounds
Reduced chest wall movement
Reduced Vocal resonance
Stony dull percussion
Investigations
CXR
USS guided aspiration
routine bloods
Exudate Features
High protein
High LDH
Transudate Features
Low protein
Low LDH
Exudate Causes
Infection
Malignancy
RA
Transudate Causes
Heart failure
Nephrotic syndrome
Liver cirrhosis
PE
Treatment
Treat underlying cause
If PH <7.2 (Empyema) - Drainage
If Malignancy - Drainage
If persists - Drainage
Drainage Location
5th ICS, Mid axillary line, Just above rib
Lights Criteria
Exudate if any one of follwing:
Pleura:Serum Protein > 0.5
Pleura:serum LDH > 0.4
Pleura LDH > 2/3 upper limit of normal