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pleural effusion
definition
pleural effusion (fluid in the chest; pleural fluid) is the collection of fluid in the pleural cavity. pleural cavity that is contained in the cavity between the membrane that lines the lungs and chest cavity. under normal circumstances, not only found a thick layer of fluid that separates the 2nd arrangement pleura.
Another type of fluid that can accumulate in the pleural cavity blood, pus, fluid and fluid like milk have high cholesterol.
hemotoraks (blood in the pleural cavity) is most commonly due to an injury to the chest.



Other triggers are:
- Rupture of blood vessels something then drain the blood into the pleural cavity
- Leaking aortic aneurysm (a prominent place in the aorta) which then drain the blood into the pleural cavity
- Blood clotting problems.
blood in the pleural cavity is not frozen with excellent, easy to generally issued melelui something needle or tube.
empyema (pus in the pleural cavity) can take place when pneumonia or lung abscess spreads into the pleural cavity.
empyema can be a complication of:
- Pneumonia
- Infections of the chest injury
- Chest surgery
- Rupture of the esophagus
- Abscess in the abdomen.
kilotoraks (liquid like milk in the chest cavity) caused by an injury to the main lymph channels in the chest (thoracic duct) or by obstruction due to a tumor.
pleural cavity is filled with a liquid of high cholesterol content takes place due to chronic pleural effusion due to tuberculosis or rheumatoid arthritis.

cause
under normal circumstances, the pleural fluid is formed in small amounts to lubricate the surface of the pleura (pleural membrane is not thick that lines the chest cavity and lungs wrap).
effusion may last 2 are not the same type:
transudativa pleural effusion, usually due to an abnormality in the normal pressure in the lungs.
type effusion transudativa very often found that congestive heart failure.
eksudativa pleural effusion due to inflammation of the pleura took place, which is often caused by lung disease.
cancer, tuberculosis and other lung infections, drug reactions, and sarcoidosis asbetosis is part parable disease that can lead to pleural effusion eksudativa.
Another trigger of pleural effusion are:

heart failure
Low blood protein
cirrhosis
pneumonia
blastomikosis
koksidioidomikosis
tuberculosis
histoplasmosis
cryptococcosis
abscess under the diaphragm
rheumatoid arthritis
pancreatitis
pulmonary embolism
tumor
Systemic lupus erythematosus
cardiac surgery
chest injury
drugs (hydralazine, procainamide, isoniazid, phenytoin, chlorpromazine, nitrofurantoin, bromocriptine, dantrolen, procarbazine)
pemasanan hose to hose intravenous food or unfavorable.


symptom
the signs are very often found (regardless of the type of fluid is collected and triggers) are shortness of breath and chest pain (usually sharp shape and getting worse when patients cough or breathe in).
sometimes the majority of patients do not show signs though.
Other signs that may be found:
- Cough
- Hiccups
- Rapid breathing
- Abdominal pain.
diagnosis
on physical control, with the help of a stethoscope to hear there was a decrease respiratory tone.
to help confirm the diagnosis, performed the following controls:
chest X-rays
chest radiograph is generally the first step is done to diagnose pleural effusion, which ultimately show no fluid.


ct scan of the chest
ct scans clearly depict the lungs and fluid and can show no pneumonia, lung abscess or tumor
chest ultrasound
Ultrasound can help ascertain the location of the collection of small amounts of fluid, workable until discharge.
torakosentesis
trigger and type of pleural effusion can generally be determined by the parable did control fluid obtained through the torakosentesis (taking liquid through a needle inserted something in between the ribs into the chest cavity under the influence of a local anesthetic).
biopsy
torakosentesis when the trigger can not be determined, then a biopsy is done, where the parable of the outer pleural arrangement is taken to be analyzed.
at approximately 20% of patients, even though they had done a thorough control, hold the trigger of pleural effusion can not be determined.
pleural fluid analysis
bronchoscopy
bronchoscopy is sometimes done to help get the collected fluid source.nem dan cilastin, Piperacillin dan tazobactam, Clindamycin dan Piperacillin.

treatment
when the amount of liquid a little, maybe just need healing done on the trigger.
when the number of cairannnya much, to result in suppression or shortness of breath, then take action undertaken drainage (discharge collected).
fluid can flow through the procedures torakosentesis, where something needle (or tube) is inserted into the pleural cavity. torakosentesis usually done to make a diagnosis, but the procedure can also be issued a fluid, 5 liters.
when the amount of fluid that needs to be removed more and more, then put something through the wall of the chest tube.
the empyema was given antibiotics and pus expenditure undertaken.
if pus is very thick or has been collected in the fibrous, pus drainage more difficult then doing as well as some of the ribs must be removed to be fitted hoses are getting bigger. done sometimes need surgery to cut the outer structure of the pleura (decortication).
on tuberculosis or koksidioidomikosis given a long period of antibiotic therapy.
due to collection of fluid in the pleural tumors are difficult to treat due to fluid leaning back to form quickly.
drainage of fluid and sometimes shy antitumor drug delivery course of subsequent fluid collection.
if the fluid collection continues, workable pleural cavity closure. entire fluid discharged through the hose something, then put irritants (eg doxicycline solution or powder) into the pleural cavity. These irritants can make an arrangement pleural 2nd until there will be no additional fluid collection area area.
when blood enters the pleural cavity is generally issued through the hose something.
The hose passes can also be included to help solve the drug blood clots (eg streptokinase and streptodornase).
if bleeding persists or if blood can not be removed through the tube, then it took surgery done.
kilotoraks healing to be done to repair damage to the lymph channels.
can be done surgically or delivery of anticancer drugs to tumors that block the flow of lymph.
the pharmacological management of pleural effusion depends on the etiology of the condition. as parable, medical management nitrates (nitroglycerin) and diuretics (furosemide) for congestive heart failure and pulmonary edema, effusions parapneumonia and antibiotics for empyema, and anticoagulants (heparin) for pulmonary embolism.
premises in patients parapneumonic effusions, empyema and effusion berhuungan with esophageal perforation and abscess intraabdmen, antibiotics must be given by the initial conditions are known at the time.
determination of antibiotic should be based on a suspected trigger of microorganisms as well as the total clinical picture. consideration as of age, the patient, disability, disease duration, situation (treatment vs. commune residence) as well as the sensitivity of local organisms. variety of single compounds as well as an efficient antimicrobial combination therapies exist. coverage generally must include anaerobic organisms. countless choices ampicillin and sulbactam, imipe