Pleural Effusion Flashcards
1
Q
pleural effusion
A
- aka hydrothorax
- type of 3rd spacing
- fluid accumulation between pleura
- fluid moves from vasculature into IS of membrane
- increased seepage and/or decreased drainage (problem with transcapillary exchange)
2
Q
types of fluid
A
- Inflammatory fluid (exudate d/t infltm)
- made up of plasma, proteins, and defense cells, has
high protein content
- made up of plasma, proteins, and defense cells, has
- Transudate
- non-imflm fluid with decreased protein content
- Empyema
- pus/purulent exudate d/t infection
- Hemothorax
- blood fills the pleural space d/t bv injury
- Chylothorax
- lymph fills the pleural space
3
Q
etiology
A
- usually d/t CHF (causing pooling of blood as vessels become congested d/t failure of heart to circulate blood) -> increased CHP -> transudate is pushed from capillaries into IS of membranes -> pleural space/cavity
- lung infection -> inflmtn + increased cap permb + purulent exudate shifts into IS of membrane
- lung cancer -> inflmtn -> exudate
- pulmonary infarction -> injury d/t ischemia/infection/cancer -> inflmtn -> fluids shift (exudate)
4
Q
patho
A
i. fluid enters capillaries of parietal membranes
ii. drains into parietal lymphatic vessels
iii. if entry exceeds drainage, then fluid accum will lead to pleural effusion
5
Q
manifestations
A
- depends on cause and volume
- dyspnea d/t impact of ability to inflate lungs; common)
- decreased chest/lung expansion
- pleuritic pain (trying to push air into the lungs, but have compression and pressure on the lung, causing pain)
*may or may not have pleuritic pain
6
Q
diagnosis
A
- CXR
- US/ CT
7
Q
treatment
A
- based on cause
- thoracentesis and fluid analysis
8
Q
thoracentesis
A
- gradual drainage of fluid using chest tube
- done asap to avoid solidification
9
Q
could you use a volume expander to treat pleural effusion?
A
no do not use one in this case as we do for paracentesis of fluid in abdomen because the volume of the pleural space/cavity is relatively small
