Pleural Effusion and Empyema Vocabulary

Vocabulary flashcards covering key terms, definitions, diagnostics, causes, and interventions related to pleural effusion and empyema.

Pleural Effusion

Excess accumulation of fluid in the pleural space that separates the visceral and parietal pleura and compresses the lungs.

Transudative Pleural Effusion

A thin and watery effusion containing few blood cells and little protein, caused by fluid moving from pulmonary capillaries into the pleural space without primary pleural surface involvement.

Exudative Pleural Effusion

An effusion resulting from diseased pleural surfaces (inflammation, infection, or malignancy) that contains high protein content and cellular debris.

Congestive Heart Failure (Pleural Effusion)

The most common cause of transudative pleural effusion, with left-sided heart failure being more likely than right-sided heart failure to produce an effusion.

Hepatic Hydrothorax

A condition in patients with liver cirrhosis where ascites fluid passes from the peritoneal space to the pleural space, causing a transudative pleural effusion.

Nephrotic Syndrome

A disorder causing decreased plasma oncotic pressure, generally resulting in a bilateral transudative pleural effusion.

Empyema

Pus in the pleural space that develops as a result of inflammation, such as untreated bacterial pneumonia.

Chylothorax

The presence of chyle in the pleural space, caused by trauma to the neck or thorax.

Chyle

A white, milky fluid produced from food in the small intestine, transported by the thoracic duct to the neck where it enters venous circulation.

Hemothorax

Blood in the pleural space, mostly caused by penetrating or blunt chest trauma, defined by a fluid hematocrit of at least $50\%$.

Moderate Pleural Effusion

A pleural effusion with a fluid volume ranging from $500\,ml$ to $1500\,ml$, which is when chest pressure typically begins to develop.

Large Pleural Effusion

A pleural effusion with a fluid volume greater than $1500\,ml$.

Exudative Pleural Fluid Diagnostic Criteria

Pleural fluid findings characterized by protein $>2.9\,g/dL$, cholesterol $>45\,mg/dL$, or lactate dehydrogenase $>60\%$ of the upper limit for serum.

Malignant Mesotheliomas

A cause of exudative pleural effusion arising from chronic exposure to asbestos.

Meniscus Sign

A radiologic finding on chest X-ray where subdiaphragmatic or pleural fluid runs up the lateral chest wall, producing a band of soft tissue of water density.

Thoracentesis

A procedure to remove fluid from the pleural space between the outer lung lining and chest wall by inserting a needle into the thorax after administering local anesthesia.

Thoracostomy

Chest tube insertion, normally placed in the $4^{th}$ or $5^{th}$ intercostal space at the midaxillary line, using a No. 28 to No. 36 French gauge tube for adults.

Pleurodesis

A medical procedure that involves the adhesion of the visceral and parietal pleura.

Small Pleural Effusion ABG Pattern

Acute alveolar hyperventilation with hypoxemia (acute respiratory alkalosis), featuring elevated pH and decreased $\text{PaCO}_2$, $\text{HCO}_3^-$, and $\text{PaO}_2$.

Large Pleural Effusion ABG Pattern

Acute ventilatory failure with hypoxemia (acute respiratory acidosis), featuring decreased pH, elevated $\text{PaCO}_2$ and $\text{HCO}_3^-$, and decreased $\text{PaO}_2$.