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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 is a thin piece of tissue with 2 layers. One layer rests directly on the lungs. The other rests on the chest wall. There is normally a small amount of fluid between these layers. This fluid helps your lungs move easily when you breathe.

The Lungs

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

  • Blood tests may show signs of an infection.
  • X-ray, CT, or ultrasound pictures may show fluid around your lungs or signs of infection. You may be given contrast liquid before the pictures are taken to help healthcare providers see your lungs better. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid.
  • A thoracentesis is a procedure to take fluid out of your chest through a needle put between your ribs. The fluid may be sent to a lab for tests.

How is pleural effusion treated?

Treatment depends on the cause of your pleural effusion and your symptoms. 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.
  • 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.
  • Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
  • 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.

What can I do to manage my symptoms?

  • Use pressure to decrease pain. Hold a pillow against your chest when you cough or take a deep breath.
  • Do not smoke , and do not allow others to smoke around you. If you smoke, it is never too late to quit. Smoking increases your risk for lung infections such as pneumonia. Smoking also makes it harder for you to get better after you have a lung problem. Ask your healthcare provider for information if you need help quitting.
  • Drink liquids as directed and rest as needed. Liquids help to keep your air passages moist and better able to get rid of germs and other irritants. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. You may feel like resting more. Slowly start to do more each day. Rest when you feel it is needed.
  • 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.
    How to use and Incentive Spirometer

When should I call my doctor?

  • You feel faint, or you cannot think clearly.
  • Your lips or fingernails turn blue.
  • You find it very hard to breathe.
  • 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.

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 healthcare providers 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.

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