Health Encyclopedia

Pleural effusion

Definition

A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.

Alternative Names

Fluid in the chest; Fluid on the lung; Pleural fluid

Causes

Your body produces pleural fluid in small amounts to lubricate the surfaces of the pleura. This is the thin tissue that lines the chest cavity and surrounds the lungs. Pleural effusion is an abnormal, excessive collection of this fluid.

There are two types:

  • Transudative pleural effusion is caused by fluid leaking into the pleural space. This is from increased pressure in the blood vessels or a low blood protein count. Congestive heart failure is the most common cause.
  • Exudative effusion is caused by blocked blood vessels or lymph vessels, inflammation, lung injury, and tumors.

Symptoms

Symptoms can include any of the following:

Sometimes there are no symptoms.

Exams and Tests

Your doctor will examine you and listen to your lungs with a stethoscope.

The following tests may help to confirm a diagnosis:

  • Chest CT scan
  • Chest x-ray
  • Kidney and liver function blood tests
  • Pleural fluid analysis (examining the fluid under a microscope to look for bacteria, cancer cells, and protein level)
  • Thoracentesis (a sample of fluid is removed with a needle inserted between the ribs) 
  • Ultrasound of the chest and heart

Treatment

The goal of treatment is to:

  • Remove the fluid
  • Prevent fluid from building up again
  • Determine and treat the cause of the fluid buildup

Removing the fluid (thoracentesis) may be done if there is a lot of fluid and it is causing chest pressure, shortness of breath, or other breathing problems, such as a low oxygen level. Removing the fluid allows the lung to expand, making breathing easier.

The cause of the fluid buildup must also be treated.

If it is due to congestive heart failure, you may receive diuretics (water pills) and other medications to treat heart failure.

Pleural effusion caused by infection is treated with antibiotics.

In people with cancer or infection, the effusion is often treated by using a chest tube for several days to drain the fluid.

Sometimes, small tubes can be left in the pleural cavity for a long time to drain the fluid. In some cases, the following may be done:

Outlook (Prognosis)

The outcome depends on the underlying disease.

Possible Complications

Complications may include:

  • Lung damage
  • Infection that turns into an abscess, called an empyema, which will need to be drained with a chest tube
  • Air in the chest cavity (pneumothorax) after thoracentesis

When to Contact a Medical Professional

Call your doctor if you have symptoms of pleural effusion.

Call your doctor or go to the emergency room if shortness of breath or difficulty breathing occurs right after thoracentesis.

References

Broaddus C, Light RW. Pleural effusion. In: Mason RJ, Broaddus CV, Martin TR, et al, eds. Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 73.

Celli BR. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:chap 99.


Review Date: 8/25/2014
Reviewed By: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
adam.com
 

Our Hospitals

Alexian Brothers Medical Center

800 Biesterfield Road
Elk Grove Village, IL
60007
847-437-5500

Alexian Rehabilitation Hospital

935 Beisner Road
Elk Grove Village, IL
60007
847-640-5600

St. Alexius Medical Center

1555 Barrington Road
Hoffman Estates, IL
60169
847-843-2000

Alexian Brothers Behavioral Health Hospital

1650 Moon Lake Boulevard
Hoffman Estates, IL
60169
800-432-5005

Alexian Brothers Center for Mental Health

3436 N. Kennicott Ave.
Arlington Heights, IL 60004
847-952-7460 

Alexian Brothers Medical Group

Primary Care

Addison
Barrington
Bartlett
Elgin
Elk Grove Village
Elmhurst
Hanover Park
Mt. Prospect
Palatine
Palatine/Rolling Meadows
Poplar Creek
Schaumburg
Streamwood

Immediate Care Centers

Addison
Bensenville
Elk Grove Village
Hanover Park
Mt. Prospect
Palatine
Schaumburg

Occupational Health Centers

Addison
Bensenville
Elk Grove Village
Hanover Park
Mt. Prospect
Palatine
Schaumburg

Specialty Programs

Alexian Brothers Advanced Weight Solutions