Pleural Effusion Explained Clearly – Causes, Pathophysiology, Symptoms, Treatment,


hi welcome to MedCram let’s talk about
pleural effusions so what is a pleural effusion
well pleural effusion is basically a collection of fluid outside of the lung
so if this were your thoracic cavity your lungs would inflate to fill that
cavity almost completely however sometimes fluid can actually get in
around that area so this is fluid specifically outside of the lung not
inside the lung but outside the lung and around the lung that’s what we call a
pleural effusion now there are many causes of pleural effusions we’re going
to talk about how to differentiate those I also want to tell you how to look at
those and be able to tell when you might be seeing one of those you know in terms
of symptoms what you’re going to see is shortness of breath that’s one of the
most nonspecific symptoms is when this fluid starts to build up you’re going to
get compression of those lungs the inability to expand them and shortness
of breath is the result now just so you know these pleural effusions can occur
on one or on both sides there is a division between the two sides of the
lung that prevents fluid from going back and forth so it is possible to have it
just on one side the other type of symptoms that you might see are a
feeling of fullness or chest pain these are very nonspecific
they could be anything but that’s some of the things that you would see in a
person with a pleural effusion or it may be asymptomatic some things that you
might see on a chest x-ray the cardio silhouette will look something like this and you’ll see these things here called
the costophrenic angles usually they’re nice and sharp and someone with a mild
pleural effusion you might see some what they call blunting okay so this is the
chest film here you also might see some blunting in this area here but if you’re
starting to see blunting already then you’ve got at least 300 milliliters of
fluid in the chest as it starts to fill up you might see a tracking haziness
going up on the side and then finally if it was a very severe effusion you might
just see a complete whiteout now that’s an interesting point when you say when
you see a complete whiteout because it’s also possible to have complete
atelectasis of a lung which would also look like a whiteout and you would hate
to do a diagnostic thoracentesis in other words putting a needle in there to
try to drain fluid if in fact it’s the lung inside that’s the problem rather
than fluid around the lung pushing on it so how would you be able to tell the
difference this is kind of important by looking at a chest x-ray how can you
tell if a specific side is involved with a pleural effusion which is fluid around
the lung or atelectasis which is compression or consolidation inside the
lung you’d want to know the difference well the difference is is that a pleural
effusion if you would is fluid since it is fluid around the lung it has the
tendency to push to the other side whereas somebody with AD elected a Lexus
a consolidation of the lung has the tendency to suck towards it and so
really all you have to do is look at the trachea if you have the trachea going
towards the side that is abnormal then that is atelectasis or consolidation of
pushing towards something for instance say there’s a tumor blocking an airway
and no more air can get in so the entire lung becomes ad elected ik it will
shrink and it will suck the trachea to that side if however the trachea is
going away from the side of the problem then that means there is fluid that has
built up around the lung and is pushing the lung and all of its contents away so
again you will know if there’s total white out of one side of the lung if it
is a pleural effusion generally by looking at the trachea if it is being
pushed away from that side it is generally a pleural effusion well let’s
talk about how we analyze it this fluid now we said that there were many
different types of causes for pleural effusion and and there is congestive
heart failure cirrhosis kidney problems malignancies autoimmune conditions
infections all of these things can cause Laurel effusions and really there is a
way to go through and try to figure out what it is that’s causing it and the
best way to do that is to obtain a sample of fluid we’re dealing with fluid
that is around the lung okay this is very stylistic way of
looking at it and we’ve got sort of the lung going up like this so what we’re
doing here is we’re looking at someone’s back at their side okay here’s the
there’s the lung here and this is their back okay now in their in their back they’ve got ribs so here we have the
chest wall and here we have the lung and here we have fluid between the chest
wall and the lung and the way we go about getting to this fluid is we can
use an ultrasound machine that will allow us to see it so an ultrasound
probe if you will will look here and we’ll be able to see on the screen where
there is fluid but you remember from Anatomy that underneath each rib is a
vascular bundle okay and underneath each one is a vein so put a little dot here
vein and artery and a nerve the way I remember that is Van vein artery nerve
bundle underneath each one of these ribs so when you stick the needle in which is
what we’re going to do we always want to go over just over the rib and as soon as
we get into that area then we will advance a very soft catheter into that
fluid and will suck out the fluid now sticking the needle in too far could hit
the lung that can cause a pneumothorax and that’s why we want to make sure that
it’s soon as we get in so at this point here
is when we start the thread via cell de jure technique the catheter and then
pull that needle out so as the fluid is coming off this doesn’t come up and hit
the needle okay so now when we get that fluid we send it off for an analysis and
we’ll talk about that in the next lecture so let’s just review again we
talked about what a pleural effusion is it’s fluid around the lung we talked
about how to identify it on a chest x-ray by the blunting of the
costophrenic angles we talked about what kind of symptoms the patients might have
shortness of breath chest pain chest tightness we also talked about how to
get that fluid out to analyze it and that’s called the thoracentesis and the
specific way of putting that in so that you limit the amount of damage and
bleeding that it can occur using an ultrasound and now once we have that
fluid we’ll be able to send it off and we’ll make a diagnostic approach on to
what exactly is this pleural fluid coming from so join us for the next
lecture thank you you you

53 thoughts on “Pleural Effusion Explained Clearly – Causes, Pathophysiology, Symptoms, Treatment,

  1. I'm a new nurse working on a clinical decision unit and I see all different kinds of diagnoses. These videos help me see the whole picture. Thank you!

  2. So basically it's not your drinking water or anything? I'm 14 and I'm worry as hell. I don't have any of the symptoms but I still think I have it. When I drink something cold I can fell something cold going towards my lungs. Should I see a doctor or what. Someone please tell me!!!

  3. Can you also have coughing problems symptoms. I had a terrible pain in my back, so painful I had to lay on my back for hours for the intense pain to stop. I went to the doctor a couple weeks later and he looked at me side ways. The lady checking me in had never heard of it.  I had lab work done but he didn't mention my Pleural problem. Great videos , I watched all three and diagram it also . So lets see what happens next. Ultra sound I hope..

  4. I currently have both. Also fibrosis from cvid, or granulomataous lung disease. Why is everyone so slow in my care? I just get ivig monthly and to many antibiotics. Nobody seems to be helping me really. Why? I asked if I'm gonna die soon and he wouldn't say yes or no. But point is, some people have effusion and atelectasis. Save me science! Hurry!

  5. You make people more intelligent while ""FULL LEARNED DOCTORS WITH HALF KNOWLEDGE"" Does mistakes…?
    Doc Was Amazed!!! while me asking the questions precisely,
    Thank You Once Again.

  6. I have pleural Effusion and Pericarditis, IT HURTS. Doctor told me it is probably infection cusing it but they never took a sample from the fluid around my lungs!!!!

  7. Thank you Dr for good knowledge.
    Can we do sucking water by machine outside lungs in case of low Ejection Fraction of heart causing water around the lungs .

  8. Thanks so much. The lecture was a great refresher course. I think it might be beneficial to tell people that the pleural effusion is present in the pleural space, the 2 layers that surround the lung and chest cavity, were a small amount of fluid exists to allow the tissue layers to slide painlessly against each other.

  9. I have a slight bubbling sensation or it feels like a movement of air within my chest cavity underneath my left nipple more towards my sternum. It's only noticeable at night when I'm adjusting my position in bed or bending over/exerting myself. I do experience what feels like nerve pain or bone pain in that area. I'm a smoker but I don't feel like my lung capacity has changed and I couldn't say whether or not I've been experiencing shortness of breath. Does this sound like a pleural effusion?

  10. Most interesting video. I've had 2 thorsentesis, of right lung area. Had two nodules of the right lung biopseyed, and both came back negative, for cancer. Recently had anther xray, and xray showed returning of plural effusion.
    I've had irritation of the bronchial ares, and must say, that your information may be the problem.
    Now I will have to tactfully suggest this to my pulmonary doctor, (So he will discover, rather than as a result of your treatment suggestion.)
    Thanks for posting.
    Ron

  11. I'm in radiography school right now and want to advance beyond that at some point and these are great concise videos. Thank you for these, they help me so much when I study pathology. Sharing with my classmates!

  12. Where did you discuss treatment? Pulling out the fluid and testing it is not treatment in my mind. What if it is caused by pancreatitis? If you heal the pancreas will the fluid level stop increasing or even decrease on its own. My dog has pleural effusion. They have run multiple tests and cant find a cause.

  13. U have taught us in a very in a very interesting way.Can u please allow us to watch next videos on pleural effusion?

  14. I came here because my mom had pleural effusion and the doctors cant seem to figure out what is causing it. She doesnt have any chest pains but had edema on her feet. She had the fluid drained and biopsied but it was negative for cancer. We went back and forth to the hospital because the first catheter tube that was inserted to drain the fluid had infection so they have to remove it and insert another tube to keep draining the fluid because it just won't stop. The doctors recomend we have to undergo PET scan which is very expensive and we are already financially drained. Right now she is still carrying this catheter tube with a leg bag and the fluid is still draining around 100-200 cc everyday. Please help

  15. Very beautifully and clearly explained presentation! Thank you for making me understand better! Thank you so much from Malaysia 🇲🇾 7/8/2019

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