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Arch Bronconeumol. 2017 Nov;53(11):629-636. doi: 10.1016/j.arbres.2017.04.018. Epub 2017 Jun 19.

Diagnosis and Management of Pleural Transudates.

[Article in English, Spanish]

Author information

1
Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, España. Electronic address: lferfer7@gmail.com.
2
Unidad de Medicina Pleural, Servicio de Medicina Interna, Hospital Universitario Arnau de Vilanova, Lleida, España; Instituto de Investigación Biomédica Fundación Dr. Pifarré IRBLLEIDA, Lleida, España.
3
Servicio de Neumología, Complejo Hospitalario Universitario de Santiago, Santiago de Compostela, España; Grupo Interdisciplinar de Investigación en Neumología, Instituto de Investigaciones Sanitarias de Santiago de Compostela (IDIS), Santiago de Compostela, España.

Abstract

Various clinical trials have been published on the optimal clinical management of patients with pleural exudates, particularly those caused by malignant tumors, while little information is available on the diagnosis and treatment of pleural transudates. The etiology of pleural transudates is wide and heterogeneous, and they can be caused by rare diseases, sometimes constituting a diagnostic challenge. Analysis of the pleural fluid can be a useful procedure for establishing diagnosis. Treatment should target not only the underlying disease, but also management of the pleural effusion itself. In cases refractory to medical treatment, invasive procedures will be necessary, for example therapeutic thoracentesis, pleurodesis with talc, or insertion of an indwelling pleural catheter. Little evidence is currently available and no firm recommendations have been made to establish when to perform an invasive procedure, or to determine the safest, most efficient approach in each case. This article aims to describe the spectrum of diseases that cause pleural transudate, to review the diagnostic contribution of pleural fluid analysis, and to highlight the lack of evidence on the efficacy of invasive procedures in the management and control of pleural effusion in these patients.

KEYWORDS:

Catéter pleural tunelizado; Derrame pleural; Heart failure; Hepatic hydrothorax; Hidrotórax hepático; Indwelling pleural catheter; Insuficiencia cardiaca; Líquido pleural; Pleural effusion; Pleural fluid; Pleurodesis; Pulmón atrapado; Transudates; Trapped lung; Trasudados

PMID:
28641878
DOI:
10.1016/j.arbres.2017.04.018
[Indexed for MEDLINE]
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