PLEURAL EFFUSIONS-TRANSUDATE

SUMMARY

1. LV failure: most common, not uncommon to see an isolated right-sided effusion, common after abdominal surgery (usually benign)

2. Other causes: cirrhosis, hypoalbuminemia, nephrotic syndrome.

3. In those without heart failure, perform a thoracocentesis on unilateral, asymmetric or diuretic-nonresponsive effusions.

4. Dyspnoea in pleural effusions is due to increased intra-thoracic volume, not compression of the lung.

5. Removal of large pleural effusions may lead to a transient fall in pO₂ in the first 12 hours, until atelectatic alveoli can re-expand.

6. Removal of 1.4-2L can lead to re-expansion pilmonary oedema.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].