Respiratory Medicine » Lung & Pleura » Pleural effusion

Pleural effusion

Pleural effusion is defined as an abnormal accumulation of fluid in the pleural space. Pleural effusions are of two types - Transudate effusions (passively secreted fluid, due to a high hydrostatic pressure or a low oncotic pressure).) occurs with alteration of systemic factors that influence the formation and absorption of pleural fluid (e.g., hypoproteinaemia and increased pulmonary venous pressure). Commonest causes of transudate effusion are CCF and nephrotic syndrome. Exudative effusion (actively secreted fluid, e.g. due to inflammation) occurs with alteration of local factors that influence the formation and absorption of pleural fluid (e.g., infection and malignancy). Commonest causes of exudate effusion are tuberculosis and malignancy. These two can be distinguished by lactate dehydrogenase (LDH), protein levels or specific gravity of the fluid. Pleural tap is very often resorted to both for diagnostic and therapeutic purposes.

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