Pleural Effusion

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Overview

Pleural effusion is the accumulation of fluid in between the parietal and visceral pleura, called pleural cavity. It can occur by itself or can be the result of surrounding parenchymal disease like infection, malignancy or inflammatory conditions. Pleural effusion is one of the major causes of pulmonary mortality and morbidity.

All healthy humans have a small amount of pleural fluid that lubricates the space and facilitates normal lung movements during respiration. This delicate balance of fluid is maintained by the oncotic and hydrostatic pressure and the lymphatic drainage; disturbances in any one of these systems can lead to a build-up of pleural fluid.

Symptoms

You might not have any. You're more likely to have symptoms when a pleural effusion is moderate or large-sized, or if there is also inflammation.

If you do have symptoms, they may include:

Shortness of breath

Chest pain, especially when breathing in deeply (This is called pleurisy or pleuritic pain.)

Fever

Cough

Causes

A wide range of things can cause a pleural effusion. Some of the more common ones are:

Leaking from other organs. This usually happens if you have congestive heart failure, when  your heart doesn't pump blood to your body properly. But it can also come from liver or kidney disease, when fluid builds up in your body and leaks into the pleural space.

Cancer. Usually lung cancer is the problem, but other cancers that have spread to the lung or pleura can cause it, too.

Infections. Some illnesses that lead to pleural effusion are pneumonia or tuberculosis.

Autoimmune conditions. Lupus or rheumatoid arthritis are some diseases that can cause it.

Pulmonary embolism. This is a blockage in an artery in one of your lungs, and it can lead to pleural effusion.

Risk factors

Smoking and drinking alcohol, as these can cause heart, lung and liver disease, which can lead to pleural effusion.

History of any contact with asbestos.

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Complications

Pleural effusions can be complicated or uncomplicated. Uncomplicated pleural effusions contain fluid without signs of infection or inflammation. They’re less likely to cause permanent lung problems.

Complicated pleural effusions, however, contain fluid with significant infection or inflammation. They require prompt treatment that frequently includes chest drainage.

Pleural effusion can be a sign of severe symptoms with some diseases. In 2021, some scientistsTrusted Source found that people with COVID-19 who developed pleural effusion were more likely to have severe inflammation and complications, which could affect their chances of recovery.

Treatment can also lead to complications.

Minor complications from more invasive treatments can include slight pain and discomfort, which often go away with time. More serious complications will depend on the severity of the condition, the cause, and the treatment used.

Serious complications can include:

pulmonary edema or fluid in the lungs, which can result from draining fluid too quickly during thoracentesis

partial collapsed lung

infection or bleeding

empyema, when there is pus in the pleural space

trapped lung, when a layer formsTrusted Source around the lung that prevents it from expanding

Prevention

Smoking and high blood pressure put you at greater risk of getting pleural effusion. Avoid smoking altogether, and seek help if you would like to quit. Find healthy ways to manage stress, and aim for 7-8 hours of sleep a night. Get in the habit of washing your hands frequently to avoid exposure to viruses or bacteria.