Transudative Pleural Effusion

How to Cite This Chapter: Wongkarnjana A, Hambly N, Sładek K, Jankowski M. Transudative Pleural Effusion. McMaster Textbook of Internal Medicine. Kraków: Medycyna Praktyczna. Accessed May 31, 2024.
Last Updated: February 13, 2022
Last Reviewed: February 13, 2022
Chapter Information

Also see Pleural Effusion.

Definition and Etiology

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, cirrhosis, mitral stenosis, diseases of the pericardium, pulmonary embolism (rare), hypothyroidism, hypoalbuminemia, nephrotic syndrome, peritoneal dialysis, and urinothorax (presence of urine in the pleural cavity due to retroperitoneal leakage of urinoma).


Treatment is limited to management of the underlying condition. In patients with cirrhosis and recurrent transudative pleural effusions, consider transjugular intrahepatic portosystemic shunt (TIPS).

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