A pleural effusion is a lung condition where you have an abnormal buildup of fluid in the pleura, which are thin membranes lining the outside of your lungs. Your pleura make it easier to breathe and provide lubrication for the lungs, heart, and chest cavity. Therefore, if there is a buildup of fluid in the pleura, it can cause breathing difficulties and tightness.
By themselves, pleural effusions are serious and cause breathing problems, but they are treatable. However, they are particularly dangerous because there is usually an underlying cause for pleural effusions. Until the underlying cause is diagnosed and dealt with, pleural effusions will return and become more and more dangerous with each recurrence.
First and foremost, it is important to determine the underlying condition that is causing your pleural effusion. The most common causes of pleural effusions include heart problems, kidney disease, cirrhosis, and pulmonary embolisms. Treating these conditions will vary from one condition to another, but it is an essential part of diagnosing and permanently curing pleural effusions.
In cases of serious or recurring pleural effusions, you may need therapeutic thoracentesis. This procedure is where a doctor uses a needle to extract air or fluid from the pleura. While therapeutic thoracentesis will provide instant relief from your effusion, it does not treat the underlying condition. Therefore, additional testing and treatment may be necessary.
Medications are another common treatment for people with pleural effusions and could include one of the following drugs.
Diuretics are medications that help drain excess fluid from the body, including the lungs. Diuretics, including bumetanide and ethacrynic acid, are typically administered orally or via an IV, depending on the drug you need. Diuretics are typically used when heart failure is causing the pleural effusion.
In situations where pleural effusions are very serious and recurring and other medications do not help, you may need a sclerosing agent. Sclerosing agents, such as chromated glycerine and hypertonic saline, produce scarring in the lungs, which results in fibrosis.
In many instances, pleural effusions can result from a bacterial infection. If this is the case, you will need antibiotics, such as imipenem or penicillin, to cure the infection. Your doctor can then drain the fluid from the lungs and get you on the road to recovery.
Pleurodesis is a combination treatment consisting of medications and drainage. First, your doctor administers a medication to induce inflammation between the lungs and chest cavity, usually with a sclerosing agent. Next, they will drain the fluid from the lungs. Finally, a drug will be administered that keeps the pleura together so that future fluid cannot build up in the lungs.
Drainage and medications are the preferred treatments for pleural effusions. However, they cannot always cure the condition, and your effusions may return again and again. If this is the case, you may need surgery to repair your pleural effusion permanently.
A video-assisted thoracoscopic surgery is where a doctor uses a video-guided device to examine the pleural cavity and remove tissue from it for testing. This procedure is necessary if your doctor thinks that cancer or a serious condition is the cause of your pleural effusion.
In the case of a serious lung infection, you may need an open thoracotomy. This procedure is when your chest is cut open, and infectious tissue is removed through the opening. Finally, you may also need a shunt installed in your lungs to redirect built-up fluid out of the lungs and into the abdomen, where it is then removed from the body.
If left untreated, pleural effusions can be serious and even life-threatening. Therefore, it is important to receive a quick diagnosis of your pleural effusion and underlying condition. You can then have the pleural cavity drained and the underlying condition treated, and you can live a fairly normal life.