pleural effusion  

classification

- type of parapneumonic effusion

- type of pleural fluid

type of parapneumonic effusion

- uncomplicated : no infection

- complicated : infection with require thoracotomy or docortication

 

type of pleural fluid

- exudative fluid

- transudative fluid

**วิธีการแยก exudative vs transudative fluid ให้ใช้ Light criteria

pathogenesis

- mechanism of pleural effusion

mechanism of pleural effusion

- change in pleural pressure balance

- impaired lymphatic drainage

- increased mesothelial and capillary permeability

investigation

- thoracentesis

- imaging

 

thoracentesis

- indication thoracentesis

- Light criteria มีอะไรบ้าง

indication thoracentesis

- frankly purulent fluid

- pH

- loculated

- bacteria in G/S, C/S

 

Light criteria มีอะไรบ้าง

** 1/3 ข้อ ถือว่าเป็น exudative fluid) : protein, LDH

imaging

- CXR

- ultrasound

- CT chest

 

treatment

- supportive Rx

- chemical pleurodesis

 

supportive Rx

- supportive Rx for exudative fluid

- supportive Rx for transudative fluid

supportive Rx for exudative fluid

- tube thoracostomy

 

supportive Rx for transudative fluid

- Rx u/d

- diuretic Rx for fluid overload

- often paracentesis

chemical pleurodesis

- วิธีการทำ chemical pleurodesis

วิธีการทำ chemical pleurodesis