Normally 1 to 15 mL of fluid in the pleural space
Alterations in the flow and/or absorption of this fluid lead to its accumu...
Underlying disease determines most systemic symptoms.
Patient may be asymptomatic until the amount of fluid is large enough to cause cardiorespiratory compromise/distress.
Dyspnea and c...
Supportive measures:
Maintain adequate
Oxygenation
Fluid status
Nutritional balance
Antipyretic agents when febrile
Pain control
Treat the underlying disease:
Antibiotics for infecti...
Clinical improvement usually within 1 to 2 weeks
With empyemas, the patient may have fever spikes for up to 2 to 3 weeks after improvement is noted.
Beers SL, Abramo TJ. Pleural effusions. Pediatr Emerg Care. 2007;23(5):330–334. [View Abstract on OvidInsights]
Buckingham SC, King MD, Miller ML. Incidence and etiologies of c...
511.9 Unspecified pleural effusion
510.9 Empyema without mention of fistula
511.81 Malignant pleural effusion
012.00 Tuberculous pleurisy, unspecified
511.89 Other specified forms of effusion, e...
Q: When will the chest radiograph findings become normal?
A: They may take up to 6 months (or longer) to return to normal appearance.
Q: When will the pulmonary function tests normalize?
A: Depending...
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FIGURE 82.1. Chest radiograph of older child with congestive heart failure. Note cardiac enlargement and evidence of pulmonary venous congestion.
FIGURE 82.1. Chest radiograph of older child with congestive heart failure. Note cardiac enlargement and evidence of pulmonary venous cong...
FIG. 11.27. Pneumonia with large pleural effusion. This child presented with bacterial pneumonia and respiratory distress, presumed to be caused in part by the large pleural effusion. In the emergency department, a pleural catheter ("pigtail") was placed for drainage, using the Seldinger technique.
FIG. 11.27. Pneumonia with large pleural effusion. This child presented with bacterial pneumonia and respiratory distress, presumed to be ...
FIG. 16.15. Pleural effusion. A: Bilateral pleural effusions in a patient with metastatic nodules scattered throughout both lungs, primary unknown. A small left pleural effusion obliterates the left costophrenic angle, with an ill-defined margin. There is a larger right pleural effusion, also with an ill-defined margin, extending along the axillary margin of the lung. There is a little atelectasis in the anterior segment of the right upper lobe, abutting on the outer aspect of the lesser fi...
FIG. 16.15. Pleural effusion. A: Bilateral pleural effusions in a patient with metastatic nodules scattered throughout both lungs, primary...
<bold>Fig C 2-1 Congestive heart failure.</bold> Diffuse bilateral symmetric infiltration of the central portion of the lungs along with relative sparing of the periphery produces the butterfly, or bat's wing, pattern. The margins of the edematous lung are sharply defined. The consolidation is fairly homogeneous and is associated with a well-defined air bronchogram on both sides.<sup>6</sup>
<bold>Fig C 2-1 Congestive heart failure.</bold> Diffuse bilateral symmetric infiltration of the central portion of the lungs ...
<bold><italic>FIGURE 6.64.</bold></bold> Apical four-chamber view recorded in an elderly patient with long-standing mild systemic hypertension and congestive heart failure due to predominantly diastolic dysfunction. Note the evidence of significant atrial enlargement, which is a marker of long-standing diastolic dysfunction. LA, Left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle
<bold><italic>FIGURE 6.64.</bold></bold> Apical four-chamber view recorded in an elderly patient with long-standin...
<bold>Figure 4.27. Kerley lines in patients with congestive heart failure. A,</bold> AP radiograph shows prominent interstitial markings in both bases with a fine interlacing pattern. <bold>B,</bold> detail view shows the linear horizontal Kerley B-lines in the periphery. <bold>C</bold> and <bold>D,</bold> detail views of two other patients show similar findings.
<bold>Figure 4.27. Kerley lines in patients with congestive heart failure. A,</bold> AP radiograph shows prominent interstitia...
<bold>Figure 5.33. Congestive heart failure and pulmonary edema. A.</bold> Frontal view shows mild pulmonary edema and pulmonary venous engorgement. <bold>B.</bold> Detail view shows the edema and prominent septal (Kerley) lines. <bold>C.</bold> Detail view in another patient shows the prominent horizontal Kerley lines.
<bold>Figure 5.33. Congestive heart failure and pulmonary edema. A.</bold> Frontal view shows mild pulmonary edema and pulmona...