Pleural Effusions & Thoracocentesis Flashcards
3 Mechanisms by which Fluid Accumulates in the Pleural Space
Increased drainage of fluid into space
Increased production of fluid by cells in the space
Decreased drainage of fluid from space
Define Intrapulmonary Pressure
Pressure within the alveoli
Define Intrapleural Pressure
Pressure in the pleural cavity
Always negative pressure
When can intrapleural pressure become positive?
Fluid collects in the pleural space making the lung unable to expand fully
Define Pleural Effusion
Abnormal accumulation of fluid in the pleural space
Main Causes of Pleural Effusion
CHF Liver failure Infection Atelectasis Cancer Trauma
Define Hemothorax
Blood in the pleural space
How does blood get into the pleural space?
Blood vessel ruptures into the space
Aortic aneurysm leaks blood into the pleural space
Pleural Fluid Types
Transudate Exudate Empyema Chyle Hemothorax
Differentiate Transudate from Exudate
Transudate: no protein in fluid
Exudate: protein in fluid
Describe an Empyema
Pus
Infection
Abscess like
Describe Chyle
Milky appearance from fat droplets or lymph
Imaging in Pleural Effusion
CXR
CT
US
Usual Causes of Massive Pleural Effusions
Cancer
Tuberculosis
Technique of Thoracentesis
Localization of pleural fluid Preferably 5-6th intercostal space Sterilize insertion site Anesthetize Removal of fluid with syringe Follow-up radiography Catheter with 3-way stopcock Removal of fluid gradually Finish when pleural pressure is less than -20 mm H2O
