Abstract
Pleural effusions commonly occur in the critically ill and arise primarily through a combina-tion of organ failure (cardiac, renal, hepatic), sepsis and poor nutrition leading to hypoalbuminaemia. The incidence varies considerably, with estimates ranging from 8% to 60% depending on whether clinical or radiological criteria are applied. Effu-sions are typically defined in terms of transudates (protein content <30 g/dL) and exudates (<30 g/ dL). The nature and cause of a pleural effusion is usually determined by pleural fluid aspiration and analysis, together with non-invasive imaging such as chest radiography, ultrasound and computer-ised tomography (CT). Management is dependent on the underlying cause (e.g. heart failure, pneu-monia), effusion size and symptom severity. Treat-ment may be initially medical (thoracocentesis, diuretics, antibiotics), though surgical intervention (intercostal drains, pleurodesis, pleural shunts) may be required in more complex cases such as empyema or neoplasia.
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Marino, P.S. (2009). Pleural Effusions in the Critically Ill. In: McLuckie, A. (eds) Respiratory Disease and its Management. Competency-Based Critical Care. Springer, London. https://doi.org/10.1007/978-1-84882-095-1_6
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