Pleural Effusion
Allow me to discuss with you a pulmonary condition known as pleural effusion or water in the lungs.
Pleural effusion is excess fluid located between the outer surface of our lungs and our chest wall.
The common symptoms of a patient with pleural effusion include chest pain, orthopnea or inability to breathe when in supine position, nonproductive cough and exertional dyspnea or shortness of breath.
There are two kinds of pleural effusion:
1.) Transudative pleural effusion- pleural effusion with low protein and lactate dehydrogenase (LDH) concentration.
2. Exudative pleural effusion which is pleural effusion with high protein and LDH concentration.
In order to determine the disease that causes pleural effusion, doctors need to determine whether the patient has transudative or exudative pleural effusion.
The patients with transudative pleural effusion usually suffer from heart failure and/or liver failure.
Moreover, the patients with exudative pleural effusion may suffer from pneumonia or tuberculosis infection.
The other conditions that can cause pleural effusion include lung cancer, lymphoma, kidney failure, pulmonary embolism, autoimmune disease, chest trauma and some medications.
The treatment of pleural effusion is managed by targeting the underlying disease that causes the problem in the first place plus thoracentesis or drawing of fluid from the lungs using a needle.
The treatment can also involve the use of a tube inserted on the patient’s thoracic cage known as chest tube thoracostomy (CTT).
Thoracentes is less invasive compared to CTT thus it is preferred if the patient is unstable.
The CTT is chosen as the mode of treatment if the pleural effusion is likely to recur, loculated and infected .
The minimal pleural effusion usually resolved spontaneously, thus it is by observation alone.
In the Philippines, parapneumonic effusion caused by pneumonia is the most common cause of pleural effusion.