Comprehensive, Specialized Care for Patients with Pleural Effusions

At University Hospitals, we offer comprehensive, specialized care for patients with pleural effusions. Our board-certified and fellowship-trained lung specialists, including pulmonologists and thoracic surgeons, work together to help patients with this condition find relief and avoid serious complications.

Your body naturally produces fluid known as the pleura in order to lubricate the thin tissues in your lungs and chest. A pleural effusion occurs when there is a buildup of an excessive amount of fluid between the layers of these tissues. There are two types of pleural effusions

• Exudative: An exudative pleural effusion may need to be drained and is the result of excess liquid, protein, blood and inflammatory cells that leak across damaged blood vessels into the pleura. Pneumonia and lung cancer are the most common causes of an exudative pleural effusion.
• Transudative: This type of pleural effusion rarely needs to be drained and is usually caused by an imbalance of pressure inside the blood vessels of the lungs. Congestive heart failure is the most common cause of a transudative pleural effusion.

Diagnostic Techniques for Lung Function Testing

Our team of lung specialists offers a wide range of techniques to diagnose pleural effusions. If you are showing any symptoms of this condition, we will first listen to your breathing and even tap your chest to listen for dullness, an indication of fluid build-up. One or a several of these diagnostic tests may be performed:

• Chest x-ray: On a chest x-ray, pleural effusions appear white while air space is black.
• Computed tomography (CT) scan: A CT scan can construct images of the inside and outside of your chest and provide more detail than a chest x-ray.
• Pleural fluid analysis: In a pleural fluid analysis, a sample of the fluid from around your lung is examined to search for germs, protein levels or cancer cells.
• Ultrasound: An ultrasound uses a probe on your chest to create images of the inside of your body. It can be helpful in locating the fluid so that a sample can be taken for pleural fluid analysis.

Comprehensive Pleural Effusion Treatment

At University Hospitals, we believe in a comprehensive approach to patient care, creating individualized treatment plans that take a patient’s health goals into consideration. A pleural effusion can be caused by an underlying medical condition such as mesothelioma, congestive heart failure or pneumonia. If this is the case, our team will create a pleural effusion treatment plan that focuses on improving the underlying condition not just pleural effusion.

For patients that have a large or inflamed pleural effusion, we have the experience and expertise to care for these more complex cases. Our team of pulmonologists and thoracic surgeons work together to look at short-term and long-term care needs to determine a path to wellness. For larger effusions, we often recommend draining as a first step to alleviate symptoms, potentially provide additional insights for diagnostics and prevent future complications. We may recommend one of the following procedures:

• Thoracentesis: This treatment uses a needle to draw fluid from around the lungs to examine under a microscope.
• Tube thoracostomy: A small incision is made in the chest wall, so a plastic tube can be inserted into the pleural space for several days.
• Pleural drain: A pleural drain may be an option for chronic pleural effusions. A catheter can be inserted through the skin into the pleural space. For this procedure, we work with patients to instruct on how and when to drain pleural effusions at home.
• Pleurodesis: A pleurodesis involves injecting an irritating substance into the pleural space. This causes the pleura to become inflamed and bind tightly to your chest wall as it heals. This procedure is often used to prevent a pleural effusion from recurring.
• Pleural decortication: This involves surgical removal of the inflammation and unhealthy tissue from the pleural space.

Learn More about Expert Care for Pleural Effusions

No matter how complex your condition, our multidisciplinary team will work with you, treat your specific issues and alleviate pleural effusion symptoms. Our surgical treatment options are offered at various UH hospitals through the UH Seidman Cancer Center. Diagnostics services and ongoing treatments are provided close to home at a variety of locations across northeast Ohio.