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Pleural Effusion, Pediatric

Richard M. Kravitz, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Accumulation of fluid in the pleural cavity 

PATHOPHYSIOLOGY

  • 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...

DIAGNOSIS

HISTORY

  • 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...

TREATMENT

GENERAL MEASURES

  • Supportive measures:

    • Maintain adequate

      • Oxygenation

      • Fluid status

      • Nutritional balance

    • Antipyretic agents when febrile

    • Pain control

  • Treat the underlying disease:

    • Antibiotics for infecti...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • 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.

DIET

When the ef...

ADDITIONAL READING

  • 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...

CODES

ICD9

  • 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...

FAQ

  • 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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