Pleural Effusion - How To Handle It?

Pleural effusion, in medical terms, is a condition characterized by an abnormal accumulation of fluids in the pleural space. The pleural space is essentially the region between the tissues that form the lining of the lungs and the chest cavity. The fluid that builds up in the pleural space may either be protein-rich (Exudative Pleural Effusions) or watery (Transudative Pleural Effusions) in nature, thus helping doctors ascertain the cause of the pleural effusion.

1. Exudative Pleural Effusions are often found to be triggered by medical conditions such as Cancer, Inflammatory diseases, Pneumonia, or Pulmonary embolism.
2. Transudative Pleural Effusions, on the other hand, maybe triggered by Cirrhosis, Kidney disorder, Heart Attack and Pulmonary embolism. People undergoing open-heart surgery are also susceptible to Transudative Pleural Effusions.

Further, people with Meigs’ syndrome, autoimmune diseases, congestive heart problems, Chylothorax, Ovarian hyperstimulation syndrome, or Tuberculosis also stand a higher risk of suffering from pleural effusions.

Symptoms:
In most of the affected individuals, pleural effusions trigger

• Shortness of breath or difficulties in breathing, a condition called Dyspnea.
• Some individuals also experience chest pain, dry cough, and Orthopnea (difficulty in breathing especially while in lying flat or in a sleeping position).

Treatment:
The first step towards effective treatment includes identifying the underlying health problem that triggered pleural effusions. Doctors work towards

1. Treating the pleural effusions.
2. Ensuring that the condition (Pleural effusions) does not recur.
3. Measures are also taken to treat the health problem that resulted in pleural effusions.

In case of severe breathing troubles, doctors may perform Thoracentesis, an invasive procedure whereby the doctor carefully inserts a needle through the chest wall to drain out the excess fluids that have accumulated in the pleural space. While Thoracentesis is known to produce fruitful results, people with chronic lung disorders or lung surgery should refrain from this procedure.

In the case of pleural effusions resulting from congestive heart failure, the use of diuretics come as a great relief. To prevent the recurrence of the condition or to deal with malignant pleural effusions, doctors may also opt for Pleural sclerosis or Pleurodesis, which involves the removal of excess pleural fluid from the pleural space.

The doctor slightly irritates the tissues of the pleural lining to create a scar. It is this scarring that results in the fusion of the two pleural layers thus filling the space between the layers and preventing the recurrence of pleural effusion. In malignant pleural effusions, patients may also require chemotherapy or radiation therapy. In extreme cases, doctors may perform Video-Assisted Thoracoscopic Surgery (VATS). In VATS, ½ -inch long incisions (1-2) are made to drain out the pleural fluid. To avoid recurrence of the effusion, antibiotic or sterile talc is placed inside during the surgery.

In the case of pleural effusion resulting in infection at the pleural space, an Open Thoracic Surgery (Thoracotomy) is carried out to treat the condition.

While there are several treatment methods for pleural effusion, proper identification of the underlying cause is imperative to recommend the line of treatment best suited for the patient.