English
Polski
Español
українська
Sundaralingam A, Grabczak EM, Burra P, et al. ERS Statement on Benign Pleural Effusions in Adults. Eur Respir J. 2024 Jul 26:2302307. doi: 10.1183/13993003.02307-2023. Epub ahead of print. PMID: 39060018.
Roberts ME, Rahman NM, Maskell NA, et al; BTS Pleural Guideline Development Group. British Thoracic Society Guideline for pleural disease. Thorax. 2023 Jul;78(Suppl 3):s1-s42. doi: 10.1136/thorax-2022-219784. PMID: 37433578.
Feller-Kopman DJ, Reddy CB, DeCamp MM, et al. Management of Malignant Pleural Effusions. An Official ATS/STS/STR Clinical Practice Guideline. Am J Respir Crit Care Med. 2018 Oct 1;198(7):839-849. doi: 10.1164/rccm.201807-1415ST. PMID: 30272503.
Hooper C, Lee YC, Maskell N; BTS Pleural Guideline Group. Investigation of a unilateral pleural effusion in adults: British Thoracic Society Pleural Disease Guideline 2010. Thorax. 2010 Aug;65 Suppl 2:ii4-17. doi: 10.1136/thx.2010.136978. PMID: 20696692.
Also see Pleural Effusion.
Definition and EtiologyTop
Transudative pleural effusions accumulate in the pleural space as a result of increase in the hydrostatic pressure in the pleural capillaries (mainly in the parietal pleura), decrease in the osmotic or oncotic pressure, or less commonly as a result of fluid translocation from the peritoneal cavity.
A transudate is a clear pale-yellow fluid with low protein and lactate dehydrogenase (LDH) levels, pH usually >7.35, and low cell counts comprising mostly lymphocytes.
Causes: Heart failure (>80% of transudates), cirrhosis (10%), hypoalbuminemia, nephrotic syndrome, atelectasis, mitral stenosis, diseases of the pericardium, pulmonary embolism (rare), hypothyroidism, peritoneal dialysis, and urinothorax (presence of urine in the pleural cavity due to retroperitoneal leakage of urinoma).
TreatmentTop
Treatment is limited to management of the underlying condition. Most transudates can be successfully treated with diuretics, making further investigations unnecessary. In patients with cirrhosis and refractory transudative pleural effusions, consider transjugular intrahepatic portosystemic shunt (TIPS) or liver transplant.
.
