Pleural Effusion and Empyema Flashcards
What is the difference between a pleural effusion and an Empyema?
Infection
Where does fluid accumulate in a pleural effusion?
The visceral and parietal pleura
What kind of lung disease are pleural effusions and Empyema?
Restrictive Lung Disorder
What are the major pathologic or structural changes associated with significant pleural effusion?
Lung compression, atelectasis, compression of the great veins and decreased cardiac venous return
What kind of fluid is thin and watery, containing a few blood cells and little protein?
Transudative
What kind of fluid is caused by inflammation, infection, or malignancy?
Exudative
What kind of pleural effusion develops when fluid from the pulmonary capillaries moves into the plural space?
Transudative Pleural Effusion
What kind of fluid develops when the pleural surfaces are diseased?
Exudative Pleural Effusion
How many people are approximately affected by Pleural Effusions each year in the United States?
1.3 million
What are some early signs and symptoms of a pleural effusion?
Pleuritic chest pain, “chest pressure” dyspnea, and cough
What are some common causes of a transudative pleural effusion?
CHF, hepatic hydrothorax, peritoneal dialysis, nephrotic syndrome, PE or infarction
What is the most common cause of pleural effusion?
CHF
In Cor pulmonale, what causes an increase in the hydrostatic drainage in the systemic circulation?
1.) increase the rate of pleural fluid formation and 2.) decrease lymphatic drainage from the pleural space because of the elevated SVP
In CHF, what causes an increase in hydrostatic pressure in the pulmonary circulation?
1.) decrease the rate of pleural fluid absorption through the visceral pleura and 2.) cause fluid movement through the visceral pleura into the pleural space
How does a pulmonary embolism cause a pleural effusion?
1.) obstruction of the pulmonary vasculature can lead to right sided heart failure 2.) ischemic infarction caused by a PE increases the permeability of the capillaries in the visceral pleura
What are some common causes of exudative pleural effusions?
Malignant pleural effusions and mesotheliomas, bacterial pneumonias, tuberculosis, fungal diseases, diseases of the gastrointestinal tract, collagen vascular diseases
What is a hemothorax?
The presence of blood in the pleural space
What are some clinical manifestations of pleural effusion obtained at the bedside?
Chest pain, decreased chest expansion, cyanosis, cough, tracheal shift, dull percussive note
What are the radiologic findings on a chest radiograph for pleural effusion?
Blunting of the costophrenic angle, fluid level on the affected side, depressed diaphragm, mediastinal shift to the unaffected side, atelectasis, “meniscus sign”
What are the respiratory care treatment protocols for pleural effusion?
Oxygen therapy, lung expansion, mechanical ventilation, and pleurodesis
