Pleural effusion

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Lungs

Pleural cavity

Respiratory system

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

Treatment aims to:

• Remove the fluid
• Prevent fluid from building up again
• Treating the cause of the fluid buildup

Therapeutic thoracentesis may be done if the fluid collection is large and causing chest pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Removing the fluid allows the lung to expand, making breathing easier. Treating the cause of the effusion then becomes the goal.

For example, pleural effusions caused by congestive heart failure are treated with diuretics (water pills) and other medications that treat heart failure. Pleural effusions caused by infection are treated with appropriate antibiotics. In people with cancer or infections, the effusion is often treated by using a chest tube for several days to drain the fluid.

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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:

• Chemotherapy
• Putting medication into the chest that prevents fluid from building up again after it is drained
• Radiation therapy
• Surgery

The expected outcome depends upon the underlying disease.

• A lung that is surrounded by excess fluid for a long time may be damaged.
• Pleural fluid that becomes infected may turn into an abscess, called an empyema, which will need to be drained with a chest tube.
• Pneumothorax (air in the chest cavity) can be a complication of the thoracentesis procedure.

Call your health care provider if you have symptoms of pleural effusion.

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

Review Date: 09/15/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).