Pleural effusion

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Lungs

Pleural cavity

Respiratory system

Fluid in the chest; Pleural fluid

Treatment may be directed at removing the fluid, preventing its re-accumulation, or addressing the underlying cause of the fluid buildup.

Therapeutic thoracentesis may be done if the fluid collection is large and causing pressure, shortness of breath, or other breathing problems, such as low oxygen levels. Treatment of the underlying cause of the effusion then becomes the goal.

For example, pleural effusions caused by congestive heart failure are treated with diuretics and other medications that treat heart failure. Pleural effusions caused by infection are treated with antibiotics specific to the causative organism. In patients with cancer or infections, the effusion is often treated by using a chest tube to drain the fluid. Chemotherapy, radiation therapy, or instilling medication within the chest that prevents re-accumulation of fluid after drainage may be used in some cases.

The expected outcome depends upon the underlying disease.

• A lung surrounded by a fluid collection for a long time may collapse.
• Pleural fluid that becomes infected may turn into an abscess, called an empyema, which requires prolonged drainage with a chest tube placed into the fluid collection.
• Pneumothorax (air within the chest cavity) can be a complication of the thoracentesis procedure.
• In rare cases, surgery is needed to remove the abscess.

Call your health care provider if symptoms suggestive of pleural effusion develop.

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

Review Date: 08/07/2006
Reviewed By: David A. Kaufman, M.D., Assistant Professor, Division of Pulmonary, Critical Care & Sleep Medicine, Mount Sinai School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network.