Body Fluids. Serous fluids Cerebrospinal fluid (CSF). Serous fluids. Pleural fluid Pericardial fluid Peritonial fluid. Pleural fluid. Pleural fluid. Between visceral and parietal pleura It is normally about 1-10ml Mositening the pleural surface An increased volum is called effusion.
the accumulation of excess fluid within the
pleural space in response to injury,
inflammation, or both
may represent a local response to disease
or may just be a manifestation of a systemic illness
Rate of Fluid Rate of Fluid
1. Altered Pleural Membrane Permeability
2. Decreased Intravascular Oncotic Pressure
3. Increased Capillary Hydrostatic Pressure
4. Lymphatic Obstruction
5. Abnormal Sites of Entry
blunting of either costophrenic angle is indicative of the
accumulation of between 250 - 500 ml of fluid
Small Pleural Effusion & Identifying Loculations
- Underlying congestive heart failure
- After recent thoracic or abdominal surgery.
colorless, clear, odorless fluid with a
WBC less than 1000 / mm3
CHF, Cirrhosis, Nephrotic Syndrome
Hypoalbuminemia, Constrictive Pericarditis,SVC Obstruction, Megi syndrome
[Pleural Fluid vs. Serum Levels]
Parapneumonic, Infections, Malignancy,
Vasculitic Disease, GI Disease, TB, PE(pulmonary embolism)
1. Pleural Protein : Serum Protein > 0.5
2. Pleural LDH : Serum LDH > 0.6
3. Pleural LDH > 200
only need 1 critical value to establish the diagnosis of exudate
appropriate treatment may produce
dramatic symptomatic relief !
A bloody pleural effusionoccurring in a patient without a history of trauma or pulmonary infarctionis Indicative of Neoplasmin 90 % of cases!
1.elevation of intracardiac pressures
2.limitation of ventricular fillng
3.reduction of cardiac output
Acute tamponade: 150-200 ml
Chronic tamponade: 1000-2000 ml
A greater than normal (10 mmHg) inspiratiory decline in systolic arterial pressure.
Pericardiocentesis needle insertion sites. The subxiphoid and the left sternocostal margin are the most commonly used sites (black dots)
Hospital stay can vary from one day to several days. If the catheter remains in place to continue draining fluid, you may need to stay in the hospital several days.
Is portal hypertension present?
SAAG >/= 1.1g/dL
= serum albumin – ascites albumin