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Pleural Effusions - Coggle Diagram
Pleural Effusions
Management
Conservative
Intercostal drain
Large effusion
Compromised respiration
Infection
Haemothorax
Surgical
Videoassissted thorascopic surgery (VATS)
Definitions
Transudate
<25g/l
Exudate
greater than 35g/l
Lights criteria
Protein ratio >0.5
LDH ratio >0.6
Pleural fluid LDH > 2/3 upper limit of normal
Glucose <3.3
pH <7.2
Causes
Transudate
Common
CCF
Liver failure
Peritoneal dialysis
Low albumin
Less common
Hypothyroidism
Nephrotic syndrome
Sarcoid
Meig syndrome
Exudate
Common
Parapnumonic
Malignancy
PE
Autoimmune eg SLE, RA
Less common
Pancreatitis
TB
Chylothorax
Haemothorax
Investigations
Imaging
Erect CXR
USS
CT
Pleural fluid
Gram stain + MC+S
Acid fast bacilli
Cytology
Biochemistry
Protein
LDH
Amylase
pH
Triglycerides