Pleural Effusion Flashcards
What is pleural effusion?
An abnormal collection of fluid in pleural space.
What should raise concern?
Large unilateral effusion
Pleural Fluid appearance
- Straw Coloured => Cardiac failure.
- Bloody => trauma, malignancy, infection.
- Turbid/Milky => empyema, chylothorax.
- Foul smelling => anaerobic empyema.
- Food Particles => oesophageal rupture.
Biochemistry
Transudates & exudates
Transudates: Protein
- Protein < 30g/L
Exudates: Protein
- Protein > 30g/L
Transudates: Conditions
Heart failure, liver cirrhosis, hypoalbuminaemia, atelectasis, peritoneal dialysis.
Exudates: Condition
Local disease, malignancy, infection, pulmonary infarction, asbestos.
Fluid pH
- 7.6 => Normal.
- < 7.3 => Pleural Inflammation.
- < 7.2 => Requires Drainage.
Glucose
Low in infection, rheumatoid Arthiritis, malignancy, oesophageal rupture & SLE.
Diagnosis:
Biochemistry tests (fluid pH & glucose), pleural aspirate, repeat pleural tap, PACXR, CT Chest, Culture, Tissue Biopsy.
Pleural Aspirate
Will diagnose malignancy in 60% => 2nd sample will increase yield.