Pleural Effusion (Fluid In the Chest or On the Lung)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Steven Doerr, MD
    Steven Doerr, MD

    Steven Doerr, MD

    Steven Doerr, MD, is a U.S. board-certified Emergency Medicine Physician. Dr. Doerr received his undergraduate degree in Spanish from the University of Colorado at Boulder. He graduated with his Medical Degree from the University Of Colorado Health Sciences Center in Denver, Colorado in 1998 and completed his residency training in Emergency Medicine from Denver Health Medical Center in Denver, Colorado in 2002, where he also served as Chief Resident.

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What is the treatment for pleural effusion?

Small transudative pleural effusions may require no treatment, while larger ones and most exudative pleural effusions require treatment. The initial treatment of choice is drainage of the pleural fluid. This is done by thoracentesis (this procedure may be both diagnostic and therapeutic), where a tube is inserted into the effusion, and the effusion is drained out. This procedure needs monitoring, and in some instances, the tube may need to remain in the pleural space for a longer period of time for continued drainage. The need for repeated thoracentesis varies from patient to patient depending on the underlying cause, the amount of effusion fluid, the type of effusion (thick, thin, malignant, or infectious, for example) and if there is recurrence of the pleural effusion.

Some pleural effusions (mainly exudative) may require surgery to break up adhesions, while others may require pleurodesis (pleural sclerosis), a procedure whereby different irritant substances or medications are inserted into the pleural space in order to fibrose and scar the visceral and pleural surfaces together. This procedure seals the pleural space so that pleural effusions have difficulty reaccumulating.

The use of medications for pleural effusions depends on the underlying cause. Antibiotics are used when there is an infectious cause, whereby diuretics such as furosemide (Lasix) may be used to slowly help reduce the size of the pleural effusion.

Medically Reviewed by a Doctor on 2/6/2015
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