Pleural Effusion: Causes, Symptoms and Treatments

There is a thin layer of fluid between the lungs and the chest wall. This fluid is essential because it acts as a lubricant between the chest walls and the lungs, when we breathe. The cavity or space between the chest wall and the lungs, in which this liquid is accumulated, is called the pleura. An abnormal increase in the fluid quantity that is present in the pleural space causes the chest wall to be separated from the lungs. This condition is known as pleural effusion.

Causes
Pleural effusion can be broadly classified into two types; transudative pleural effusion and exudative pleural effusion.

Transudative pleural effusion is the result of fluid, leaking into the pleural space. This may be because of a variety of reasons but the most common one is the failure of the left ventricle in the human heart. People suffering from complications after their heart surgeries, have also often been diagnosed with transudative pleural effusion. Pulmonary embolism and cirrhosis are also among the other common reasons of transudative pleural effusion.

Leaky blood vessels are the basic cause of exudative pleural effusion. Leaky blood vessels are caused mainly because of lung diseases. So, some of the most common causes of exudative pleural effusion are lung infections, tuberculosis, bacterial pneumonia, pulmonary embolism, breast cancer and lung cancer. Drug induced lupus are sometimes produced by some type of medications and this can also finally result in pleural effusion. Pleural effusion caused because of medication is not very acute, as the fluid in the pleural space starts reducing as soon as the medication procedure is over. Arthritis causes inflammation of body parts and in certain cases it may also cause the inflammation of the pleura. Systematic lupus erythematosus and accidental infusion of fluids, are also listed among the other major causes of pleural effusion. Among the less common reasons of pleural effusion, are the pancreatic, liver and kidney diseases, viral and fungal infections and mesotheliomia.

Symptoms
Pleural effusion starts showing its symptoms, with the compression of the lungs. Chest pain is common, but pleural effusion has also been diagnosed in people with no chest pain. The degree of pain depends on the amount of liquid accumulated in the pleura. With increase in the effusion, the lungs get less space to expand and hence breathing problems are a common symptom in people suffering from pleural effusion. If pneumonia is the cause of pleural effusion, then the symptoms may include cough and fever with empyema. Hiccups and dyspnea are among the other common symptoms of patients suffering from pleural effusion.

Treatment
The basic steps included in the treatment of pleural effusion are diagnosing the problem, the removal of the fluid and treating the basic cause, because of which it had occurred. The first step of diagnosis is a simple chest X-Ray. But the confirmation of the pleural fluid is done after an ultrasound or a CT scan or both. The next important step in the diagnosis procedure is to find out the cause of the liquid accumulating in the pleura followed by the removal of the fluid. The cause can be determined by getting a sample of the fluid. The process involved in extracting a sample of this liquid and removing a large amount of it, is called therapeutic thoracentesis. The amount of liquid removed lies within the range of 30ml to 2 liters. In certain cases the fluid is removed by inserting an intercostal drain into the pleura. In the case of people suffering from cancer, the fluid is removed by inserting a chest tube, and allowing the fluid to drain out. This process may take more than one day.

If the fluid keeps on accumulating continuously then repeated effusions of the fluid are done through chemical or surgical pleurodesis. In this process, both the pleural surfaces are scarred, hence prohibiting the accumulation of the liquid. Regardless of whatever process is undertaken to remove the fluid, antibiotics are compulsorily administered. The final step to the treatment of pleural effusion is addressing the basic cause. In case of patients suffering from bacterial pleural effusion, antibiotics can simply be used. People with cancer are treated with chemotherapy, radiation therapy or surgery. Diuretics are given to people suffering from pleural effusion caused by heart problems.

Pleural effusion caused by pneumonia, tuberculosis, bacterial infections and arthritis can be diagnosed and treated with ease. But when the root cause is not known, the diagnosis becomes extremely important. Pleural effusion in a person indicates that he is suffering from some other ailment which can even be something very serious like cancer.