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Pleural Effusions in the Critically Ill

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Respiratory Disease and its Management

Part of the book series: Competency-Based Critical Care ((CBCC))

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Abstract

Pleural effusions commonly occur in the critically ill and arise primarily through a combina-tion of organ failure (cardiac, renal, hepatic), sepsis and poor nutrition leading to hypoalbuminaemia. The incidence varies considerably, with estimates ranging from 8% to 60% depending on whether clinical or radiological criteria are applied. Effu-sions are typically defined in terms of transudates (protein content <30 g/dL) and exudates (<30 g/ dL). The nature and cause of a pleural effusion is usually determined by pleural fluid aspiration and analysis, together with non-invasive imaging such as chest radiography, ultrasound and computer-ised tomography (CT). Management is dependent on the underlying cause (e.g. heart failure, pneu-monia), effusion size and symptom severity. Treat-ment may be initially medical (thoracocentesis, diuretics, antibiotics), though surgical intervention (intercostal drains, pleurodesis, pleural shunts) may be required in more complex cases such as empyema or neoplasia.

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Author information

Authors and Affiliations

  1. Respiratory and Critical Care Medicine, Kingston Hospital NHS Trust, Kingston, Surrey, UK

    Philip S. Marino

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  1. Philip S. Marino
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Editors and Affiliations

  1. Department of Intensive Care, Guy's and St Thomas' NHS Foundation Trust, London, UK

    A. McLuckie

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© 2009 Springer-Verlag London Limited

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Marino, P.S. (2009). Pleural Effusions in the Critically Ill. In: McLuckie, A. (eds) Respiratory Disease and its Management. Competency-Based Critical Care. Springer, London. https://doi.org/10.1007/978-1-84882-095-1_6

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  • DOI: https://doi.org/10.1007/978-1-84882-095-1_6

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84882-094-4

  • Online ISBN: 978-1-84882-095-1

  • eBook Packages: MedicineMedicine (R0)

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