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Pleural Effusion

What is pleural effusion?

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.

What causes pleural effusion?

  • Heart failure or other heart and lung problems such as a pulmonary embolism (blockage of a blood vessel in the lungs)

  • Lung infections such as pneumonia or tuberculosis (TB)

  • Inflammation of the pleura, called pleurisy

  • Cancer, injury, or problems with other organs in your chest or abdomen, such as cirrhosis or pancreatitis

What are the signs and symptoms of pleural effusion?

You may have no symptoms. A pleural effusion may cause you to cough or feel short of breath. You may breathe faster than usual. You may have mild to severe chest pain that starts or gets worse when you breathe in or cough. Depending on the cause of your pleural effusion, you may have other symptoms, such as a fever.

How is pleural effusion diagnosed?

Your caregiver will examine you and listen to your heart and lungs through a stethoscope. You may need any of the following:

  • 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.

How is pleural effusion treated?

Treatment depends on the cause of your pleural effusion and how bad your symptoms are. You may need any of the following:

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

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

  • Prescription pain medicine may be given. Ask your caregiver how to take this medicine safely.

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

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

  • Drainage of extra pleural fluid may be done using 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.

  • Surgery may be needed if your pleural effusion keeps coming back or if it increases your risk for other problems.

When should I contact my caregiver?

  • You have a fever.

  • Your breathing problems do not go away or get worse.

  • Your pain does not go away or gets worse.

  • You cough up yellow, green, gray, or bloody mucus.

  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You feel faint, or you cannot think clearly.

  • Your lips or fingernails turn blue.

  • You find it very hard to 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. 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.

© 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.

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