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Pleural Effusion

An abnormal collection of fluid between the thin layers of tissue (pleura) lining the lung and the wall of the chest cavity.

PubMed Health Glossary
(Source: NIH - National Cancer Institute)

About Pleural Effusion

In some cases of pleurisy, excess fluid builds up in the pleural space. This is called a pleural effusion. A lot of extra fluid can push the pleura against your lung until the lung, or part of it, collapses. This can make it hard for you to breathe.

Sometimes the extra fluid gets infected and turns into an abscess. When this happens, it's called an empyema (em-pi-E-ma).

You can develop a pleural effusion even if you don't have pleurisy. For example, pneumonia, (nu-MO-ne-ah), heart failure, cancer, or pulmonary embolism (PULL-mun-ary EM-bo-lizm) can lead to a pleural effusion. NIH - National Heart, Lung, and Blood Institute

What works? Research summarized

Evidence reviews

[Hyperthermia combined with pleural infusion chemotherapy for malignant pleural effusion: a systematic review]

Bibliographic details: Shi HP, Zhang QN, Liu GQ, Wang XH.  [Hyperthermia combined with pleural infusion chemotherapy for malignant pleural effusion: a systematic review]. Journal of Practical Oncology 2014; 29(2): 136-143

[Lentinan for treatment of malignant pleural effusion: a meta-analysis of randomized controlled trials]

Bibliographic details: Feng D, Liu JL, Xu CA.  [Lentinan for treatment of malignant pleural effusion: a meta-analysis of randomized controlled trials]. Chinese Journal of Cancer Prevention and Treatment 2011; 18(20): 1620-1623

Diagnostic value of procalcitonin for tuberculous pleural effusion: a meta-analysis

Bibliographic details: Jiang YW, Liu P, Tang SY, Hu H.  Diagnostic value of procalcitonin for tuberculous pleural effusion: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2014; 14(6): 716-720 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=20140609

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Summaries for consumers

Intra‐pleural fibrinolytic therapy versus conservative management in the treatment of adult parapneumonic effusions and empyema

Infected purulent pleural effusions (empyema) with isolated collections (loculations) of fluid or pus (complicated parapneumonic effusions) may develop with pneumonia. Drainage of this infected fluid via an intercostal catheter is important in healing. Evidence from seven randomised controlled trials (RCTs) with 761 participants indicates that flushing the pleural space with a fibrinolytic agent such as streptokinase or urokinase may help to break down the fibrinous bands or loculations that prevent total drainage of infected pleural fluid and therefore may significantly increase the amount of pus drained. Meta‐analysis of these RCTs indicates that intrapleural fibrinolytic therapy confers a benefit in reducing the requirement for surgical intervention for patients in some studies but not in others . The safety profile of intrapleural fibrinolytics remains uncertain.

Cardiopulmonary Syndromes (PDQ®): Patient Version

Expert-reviewed information summary about common conditions that produce chest symptoms. The cardiopulmonary syndromes addressed in this summary are cancer-related dyspnea, malignant pleural effusion, pericardial effusion, and superior vena cava syndrome.

No clear evidence that corticosteroids are effective for tuberculous

Tuberculous pleural effusion results from tuberculous infection of the membrane covering of the lungs. This results in a build up of fluid around the lung that impairs breathing and may lead to restriction of lung function in the long term. Some clinicians believe that corticosteroids used in combination with antituberculous drugs can help to prevent these complications. We found no clear evidence supporting the use of corticosteroids in people with tuberculous pleural effusion, regardless of HIV status. However, only one trial evaluated the balance between benefit and harm of corticosteroids in people infected with HIV.

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Terms to know

Abscess
An enclosed collection of pus in tissues, organs, or confined spaces in the body. An abscess is a sign of infection and is usually swollen and inflamed.
Cavity
A hollow area or hole. It may describe a body cavity (such as the space within the abdomen) or a hole in a tooth caused by decay.
Effusion
The seeping of fluid into a body cavity; the fluid itself.
Heart Failure
A chronic condition in which the heart cannot pump blood properly.
Infection
The invasion and growth of germs in the body. The germs may be bacteria, viruses, yeast, fungi, or other microorganisms.
Lungs
One of a pair of organs in the chest that supplies the body with oxygen, and removes carbon dioxide from the body.
Pleura
A thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity. It protects and cushions the lungs. This tissue secretes a small amount of fluid that acts as a lubricant, allowing the lungs to move smoothly in the chest cavity while breathing.
Pleural Cavity
The space enclosed by the pleura, which is a thin layer of tissue that covers the lungs and lines the interior wall of the chest cavity.
Pneumonia
Pneumonia is an infection in one or both of the lungs. Many germs—such as bacteria, viruses, and fungi—can cause pneumonia.
Pulmonary Embolism
Pulmonary embolism, or PE, is a sudden blockage in a lung artery. The blockage usually is caused by a blood clot that travels to the lung from a vein in the leg.
Thorax
Having to do with the chest.
Tissue
A group of cells that act together to carry out a specific function in the body. Examples include muscle tissue, nervous system tissue (including the brain, spinal cord, and nerves), and connective tissue (including ligaments, tendons, bones, and fat). Organs are made up of tissues.

More about Pleural Effusion

Photo of an adult

See Also: Pleurisy, Pneumothorax, Hemothorax

Other terms to know: See all 12
Abscess, Cavity, Effusion

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