Pleural Effusion

WHAT YOU SHOULD KNOW:

Pleural effusion is fluid buildup in the space between the layers of the pleura. The pleura are thin layers of tissue that form a 2-layered lining around the lungs. One layer of the pleura rests directly on the lungs. The other layer rests on the chest wall. There is normally a small amount of fluid called pleural fluid between these layers. This fluid helps your lungs move easily when you breathe.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

A pleural effusion may cause or worsen a lung infection such as pneumonia. The pleural fluid may get infected and form a pocket of pus, which is called empyema. You may have other health problems, such as a collapsed lung.

WHILE YOU ARE HERE:

Informed consent:

This is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Rest:

Keep the head of your bed raised to help you breathe easier. You can also raise your head and shoulders up on pillows or rest in a reclining chair. If you feel short of breath, let caregivers know right away.

Medicines:

  • Diuretics may help decrease extra fluid caused by heart failure or other problems.

  • Antibiotics help prevent or treat an infection caused by bacteria.

  • Pain medicine may be given to decrease pain. Do not wait until the pain is severe before you ask for more medicine.

  • NSAIDs help decrease swelling, pain, and fever.

  • Steroids or other medicines may be given to decrease swelling.

  • Cough medicine may be given to help loosen phlegm in your lungs and make it easier to cough up.

Tests:

  • Blood tests may show infection, or they may provide information about your overall health.

  • A chest x-ray may show fluid around your lungs or signs of infection.

  • A CT scan , or CAT scan, takes pictures of your lungs. The pictures may show the cause of your pleural effusion. You may be given a dye before the pictures are taken to help caregivers see your lungs better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • An ultrasound of the chest uses sound waves to show pictures of your lungs on a monitor. An ultrasound may help caregivers find extra pleural fluid or the cause of it.

  • A thoracentesis is a procedure to take fluid out of your chest. You are given numbing medicine, and then a needle is put between your ribs. The extra pleural fluid is removed through the needle. This fluid may be sent to a lab for tests. These tests may help caregivers find the cause of your pleural effusion and the best way to treat it. You may need a thoracentesis more than once.

  • A sputum sample is collected in a cup when you cough. The sample is sent to a lab to be tested for the germ that is causing your illness. It can also help your caregiver choose the best medicine to treat the infection.

  • A biopsy is a procedure to remove a small piece of tissue from your lung or pleural lining. The tissue will be sent to a lab for tests. A biopsy may be taken with a needle, or through a small incision in your chest wall.

  • A bronchoscopy is a procedure to look inside your airway and learn the cause of your pleural effusion. A bronchoscope (thin tube with a light) is inserted into your mouth and moved down your throat to your airway. Tissue and fluid may be collected and sent to a lab for tests.

  • Thoracoscopy is a procedure to look inside your chest and perform tests or treatments. It is sometimes called video-assisted thoracic surgery, or VATS. Caregivers use a special scope to do a VATS or thoracoscopy procedure. A scope is a bendable tube with a light and camera on the end.

Treatment:

  • Deep breathing and coughing will decrease your risk for a lung infection. Take a deep breath and hold it for as long as you can. Let the air out and then cough strongly. Deep breaths help open your airway. You may be given an incentive spirometer to help you take deep breaths. Put the plastic piece in your mouth and take a slow, deep breath. Then let the air out and cough. Repeat these steps 10 times every hour.

  • Drainage of extra pleural fluid may be done using a thoracentesis or a chest tube. A chest tube may stay in your chest for days or weeks. This allows the extra fluid around your lungs to drain over time. You may need medicines put directly into your chest if the fluid does not drain out easily.

  • Pleurodesis is a procedure that causes the 2 pleural layers to stick together. This may decrease your risk for pleural effusion in the future. During a pleurodesis, the extra fluid is drained from your pleural effusion with a chest tube. Then, a medicine or chemical is put into the tube. This causes the pleural layers to become irritated and stick together. Once the pleural layers stick together, there is no room for extra fluid to collect between the layers. Pleurodesis may also be done during a thoracoscopy.

  • A pleuroperitoneal shunt allows extra pleural fluid to drain into your abdomen. The fluid is then absorbed back into your body. A shunt is a thin, flexible tube that is placed underneath your skin. One end is in your pleural space, and the other is in your abdomen.

  • Thoracotomy or other surgeries may be needed. A thoracotomy is surgery to open the chest wall. Some conditions, such as cancer, may cause your pleural effusion to come back often. If so, you may need surgery to correct the cause of your pleural effusion or to keep it from coming back. You may also need surgery to treat health problems caused by pleural effusion. Examples include surgery to remove scarring around the lung, or to remove part of the pleural lining.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Pleural Effusion (Inpatient Care)

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