Navigate Up

Seniors Center - A-Z Index

#
Q
Y
Z

Print This Page

Pleural effusion

A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.

Alternative Names

Fluid in the chest; Fluid on the lung; Pleural fluid

Causes, incidence, and risk factors

Your body produces pleural fluid in small amounts to lubricate the surfaces of the pleura, the thin tissue that lines the chest cavity and surrounds the lungs. A pleural effusion is an abnormal, excessive collection of this fluid.

There are two different types:

  • Transudative pleural effusions are caused by fluid leaking into the pleural space. This is caused by increased pressure in the blood vessels or a low blood protein count. Congestive heart failure is the most common cause.
  • Exudative effusions are caused by blocked blood vessels or lymph vessels, inflammation, lung injury, and tumors.

Symptoms

Sometimes there are no symptoms.

Signs and tests

Your doctor or nurse will examine you and listen to your lungs with a stethoscope.

The following tests may help to confirm a diagnosis:

  • Chest x-ray
  • Kidney and liver function blood tests
  • Pleural fluid analysis (examining the fluid under a microscope to look for bacteria, amount of protein, and presence of cancer cells)
  • Thoracentesis (a sample of fluid is removed with a needle inserted between the ribs) 
  • Ultrasound of the chest and heart

Treatment

The goal of treatment is to:

  • Remove the fluid
  • Prevent fluid from building up again
  • Determine and treat the cause of the fluid buildup

Removing the fluid (thoracentesis) may be done if there is a lot of fluid and it is causing chest pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Removing the fluid allows the lung to expand, making breathing easier.

The cause of the fluid build up must be treated, too.

If it is due to congestive heart failure, you may receive diuretics (water pills) and other medications to treat heart failure.

Pleural effusions caused by infection are treated with antibiotics.

In people with cancer or infections, the effusion is often treated by using a chest tube for several days to drain the fluid.

Sometimes, small tubes can be left in the pleural cavity for a long time to drain the fluid. In some cases, the following may be done:

Expectations (prognosis)

The expected outcome depends upon the underlying disease.

Complications

  • Lung damage
  • Infection that turns into an abscess, called an empyema , which will need to be drained with a chest tube
  • Pneumothorax (air in the chest cavity) after thoracentesis

Calling your health care provider

Call your health care provider if you have symptoms of pleural effusion.

Call your provider or go to the emergency room if shortness of breath or difficulty breathing occurs immediately after thoracentesis.

References

Broaddus C, Light RW. Pleural effusion. In: Mason RJ, Broaddus CV, Martin TR, et al, eds. Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier;2010:chap 73.

Celli BR. Diseases of the diaphragm, chest wall, pleura, and mediastinum. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 99.

Updated: 8/30/2012

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.


©  UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences
Supplemental content provided by A.D.A.M. Health Solutions. All rights reserved.

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on UPMC.com is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, UPMC.com is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

For UPMC Mercy Patients: As a Catholic hospital, UPMC Mercy abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices and/or procedures that contradict the moral teachings of the Roman Catholic Church.

© UPMC
Pittsburgh, PA, USA UPMC.com