The Effects of Pleural Effusion

  • D. Chiumello
  • V. Berto
  • E. Gallazzi
Conference paper


In healthy subjects, the pleural space, which is delimited by the visceral and parietal pleura, contains only a small amount of fluid, ranging from 10 to 20 ml [1]. This liquid usually originates from the capillaries of the parietal pleura and is drained by the lymphatics of the parietal pleura. However, in ill patients the fluid can originate from the visceral pleura or directly from the peritoneal cavity through the diaphragm. Basically, liquid accumulates every time there is an excess in liquid formation or a reduction in drainage. Medical or surgical patients are rarely admitted to the intensive care unit (ICU) for primary pleural disease; however, the pleura can be affected by various pulmonary or extrapulmonary conditions that promote the development of pleural effusions, which can affect the respiratory system [2].


Pleural Effusion Pleural Fluid Functional Residual Capacity Total Lung Capacity Pleural Space 
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  1. 1.
    Lai-Fook SJ (2004) Pleural mechanics and fluid exchange. Physiol Rev 84: 385–410CrossRefPubMedGoogle Scholar
  2. 2.
    Mattison LE, Coppage L, Alderman DF, Herlong JO, Sahn SA (1997) Pleural effusions in the medical ICU: prevalence, causes, and clinical implications. Chest 111: 1018–1023CrossRefPubMedGoogle Scholar
  3. 3.
    Light RW (2001) Pleural Diseases, 4th edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  4. 4.
    Bartlett JG, Finegold SM (1974) Anaerobic infections of the lung and pleural space. Am Rev Respir Dis 110: 56–77PubMedGoogle Scholar
  5. 5.
    Fine NL, Smith LR, Sheedy PF (1970) Frequency of pleural effusions in mycoplasma and viral pneumonias. N Engl J Med 283: 790–793CrossRefPubMedGoogle Scholar
  6. 6.
    Light RW, Girard WM, Jenkinson SG, George RB (1980) Parapneumonic effusions. Am J Med 69: 507–512CrossRefPubMedGoogle Scholar
  7. 7.
    Taryle DA, Potts DE, Sahn SA (1978) The incidence and clinical correlates of parapneumonic effusions in pneumococcal pneumonia. Chest 74: 170–173CrossRefPubMedGoogle Scholar
  8. 8.
    Kataoka H (2000) Pericardial and pleural effusions in decompensated chronic heart failure. Am Heart J 139: 918–923CrossRefPubMedGoogle Scholar
  9. 9.
    Fartoukh M, Azoulay E, Galliot R, et al (2002) Clinically documented pleural effusions in medical ICU patients: how useful is routine thoracentesis? Chest 121: 178–184CrossRefPubMedGoogle Scholar
  10. 10.
    Wong CL, Holroyd-Leduc J, Straus SE (2009) Does this patient have a pleural effusion? JAMA 301: 309–317CrossRefPubMedGoogle Scholar
  11. 11.
    Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr (1972) Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med 77: 507–513PubMedGoogle Scholar
  12. 12.
    Azoulay E (2003) Pleural effusions in the intensive care unit. Curr Opin Pulm Med 9: 291–297CrossRefPubMedGoogle Scholar
  13. 13.
    Roch A, Bojan M, Michelet P, et al (2005) Usefulness of ultrasonography in predicting pleural effusions <500 mL in patients receiving mechanical ventilation. Chest 127: 224–232CrossRefPubMedGoogle Scholar
  14. 14.
    Miserocchi G, D’Angelo E, Agostoni E (1972) Topography of pleural surface pressure after pneumo-or hydrothorax. J Appl Physiol 32: 296–303PubMedGoogle Scholar
  15. 15.
    Krell WS, Rodarte JR (1985) Effects of acute pleural effusion on respiratory system mechanics in dogs. J Appl Physiol 59: 1458–1463PubMedGoogle Scholar
  16. 16.
    Dechman G, Sato J, Bates JH (1993) Effect of pleural effusion on respiratory mechanics, and the influence of deep inflation, in dogs. Eur Respir J 6: 219–224PubMedGoogle Scholar
  17. 17.
    Sousa AS, Moll RJ, Pontes CF, Saldiva PH, Zin WA (1995) Mechanical and morphometrical changes in progressive bilateral pneumothorax and pleural effusion in normal rats. Eur Respir J 8: 99–104CrossRefPubMedGoogle Scholar
  18. 18.
    Vaska K, Wann LS, Sagar K, Klopfenstein HS (1992) Pleural effusion as a cause of right ventricular diastolic collapse. Circulation 86: 609–617PubMedGoogle Scholar
  19. 19.
    Venkatesh G, Tomlinson CW, O’Sullivan T, McKelvie RS (1995) Right ventricular diastolic collapse without hemodynamic compromise in a patient with large, bilateral pleural effusions. J Am Soc Echocardiogr 8: 551–553CrossRefPubMedGoogle Scholar
  20. 20.
    Kaplan LM, Epstein SK, Schwartz SL, Cao QL, Pandian NG (1995) Clinical, echocardiographic, and hemodynamic evidence of cardiac tamponade caused by large pleural effusions. Am J Respir Crit Care Med 151: 904–908PubMedGoogle Scholar
  21. 21.
    Nishida O, Arellano R, Cheng DC, DeMajo W, Kavanagh BP (1999) Gas exchange and hemodynamics in experimental pleural effusion. Crit Care Med 27: 583–587CrossRefPubMedGoogle Scholar
  22. 22.
    Brown NE, Zamel N, Aberman A (1978) Changes in pulmonary mechanics and gas exchange following thoracocentesis. Chest 74: 540–542CrossRefPubMedGoogle Scholar
  23. 23.
    Doelken P, Abreu R, Sahn SA, Mayo PH (2006) Effect of thoracentesis on respiratory mechanics and gas exchange in the patient receiving mechanical ventilation. Chest 130: 1354–1361CrossRefPubMedGoogle Scholar
  24. 24.
    Perpina M, Benlloch E, Marco V, Abad F, Nauffal D (1983) Effect of thoracentesis on pulmonary gas exchange. Thorax 38: 747–750CrossRefPubMedGoogle Scholar
  25. 25.
    Talmor M, Hydo L, Gershenwald JG, Barie PS (1998) Beneficial effects of chest tube drainage of pleural effusion in acute respiratory failure refractory to positive end-expiratory pressure ventilation. Surgery 123: 137–143PubMedGoogle Scholar
  26. 26.
    Ahmed SH, Ouzounian SP, Dirusso S, Sullivan T, Savino J, Del Guercio L (2004) Hemodynamic and pulmonary changes after drainage of significant pleural effusions in critically ill, mechanically ventilated surgical patients. J Trauma 57: 1184–1188CrossRefPubMedGoogle Scholar
  27. 27.
    Agusti AG, Cardus J, Roca J, Grau JM, Xaubet A, Rodriguez-Roisin R (1997) Ventilation-perfusion mismatch in patients with pleural effusion: effects of thoracentesis. Am J Respir Crit Care Med 156: 1205–1209PubMedGoogle Scholar
  28. 28.
    Gattinoni L, Caironi P, Valenza F, Carlesso E (2006) The role of CT-scan studies for the diagnosis and therapy of acute respiratory distress syndrome. Clin Chest Med 27: 559–570CrossRefPubMedGoogle Scholar
  29. 29.
    Gattinoni L, Caironi P, Cressoni M, et al (2006) Lung recruitment in patients with the acute respiratory distress syndrome. N Engl J Med 354: 1775–1786CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2010

Authors and Affiliations

  • D. Chiumello
    • 1
  • V. Berto
    • 1
  • E. Gallazzi
    • 1
  1. 1.Department of Anesthesiology and Intensive Care Fondazione IRCSSOspedale Maggiore PoliclinicoMilanItaly

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