Treatment and Complications of Pleural Effusion

Treatment and Complications of Pleural Effusion

Resuscitation of patient is the first step in the treatment of pleural effusion. Thoracentesis may be used as a therapeutic aid in removing fluid and allowing the lung to expand and function.

The 'ABC' technique is used internationally. The three vital aspects of resuscitation are: A for airway; B for breathing and C for circulation. Thus, the patient's airway should be patent, his breathing should be maintained and following this, his circulation should be maintained. Once the patient is stable, the underlying cause is searched for and treated.

Thoracentesis (mentioned in the previous section) may be used as a therapeutic aid in removing fluid and allowing the lung to expand and function. Tube thoracostomy (insertion of chest tube, ICD, intercostals drainage tube) may be placed to drain and treat empyemas (pus collections).

Chest physiotherapy may be required. If the underlying cause is left uncured, a pleural effusion may recur. Recurring effusions may require injection of sclerosing agents like talc or tetracycline into the pleural space. These substances cause fusion of the two layers of the pleura and obliterate the pleural space; surgery may be needed at times.

Complications of Pleural Effusion

Pleural effusion is a condition that compromises lung function by preventing its full expansion for breathing. A longstanding effusion may permanently decrease lung function; it may be associated with lung scarring. The effusion if uncured and allowed stand for a long time may get infected leading to empyema (accumulation of pus).

Thoracentesis involves placing needles into the pleural space and hence there is always a risk of pneumothorax (entry of air).

Pleural Effusion - References

1. Cecil Medicine, 23rd Ed.
2. Harrison''s PRINCIPLES OF INTERNAL MEDICINE, 17^TH� Edition
3. Macleod�s Clinical Examination, 12^th Ed.

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