What is a pleural effusion?

Posted: 22nd Feb 21 8:00 AM

A pleural effusion is a build-up of an unusual amount fluid between the linings of the lungs and the rib-cage.

The thin membrane that lines the surface of your lungs and the inside of your chest is called the pleura. Normally there is a small amount of fluid within this pleura space to help your lungs move smoothly in your chest cavity as you breathe.

If more fluid than is necessary starts to build-up between the layers then you have a pleural effusion, which can limit the movement and capacity of your lungs. The condition is also known as ‘fluid on the lungs’.

What can cause pleural effusions?

Pleural Effusion is quite common and can be caused by a wide range of conditions. For example:

Lung infections, such as pneumonia

Heart failure

Pulmonary embolism

Autoimmune conditions, such as rheumatoid arthritis

Lung cancer

Asbestos-related mesothelioma

Other asbestos-related diseases, such as diffuse pleural thickening

The majority of people who develop mesothelioma from past exposure to asbestos dust and fibres will develop pleural effusions. This is usually in the early stage of the disease and the large build-up of liquid in the pleural cavity causes servere breathlessness.

What are the symptoms caused by pleural effusions?

It is unlikely that you will suffer from any symptoms until the pleural effusion swells to a moderate or large size or there is also inflammation. Symptoms may include:

Breathlessness

Chest pain

Fever

Cough

Usually a pleural effusion is diagnosed using an X-ray or Ultra Sound scan of your chest.

How do you treat a pleural effusion?

The excess fluid within the pleural cavity between the lungs and the ribcage must be slowly and carefully drained. This usually requires a small injection of local anaesthetic. The doctor will then put a wide needle (cannula) into the side of your chest and insert a tube into the pleural cavity to drain away the fluid, which will make breathing much easier.

The fluid can return and you may have to have it drained more than once or your doctor may decide to leave a drain in place to collect excess fluid.

It can become increasingly difficult to drain fluid from the pleural cavity if the condition keeps reoccurring. To prevent further pleural effusions your doctor may decide to carry out a pleurodesis.

Pleurodesis is a procedure that sticks together the pleura membranes that line your lung and chest wall.

Sterile talc is usually used to seal up the pleural cavity between the membranes, which will prevent fluid from building up between the pleural layers. The talc is placed between the layers using a tube. This can also be done using a thoracoscope, which uses a video camera to examine the pleural cavity and aid the pleurodesis procedure.

Treating the cause of the pleural effusion

Fluid-on-the-lung is caused by other medical conditions, which will need to be diagnosed and treated to prevent the pleural effusion from happening again.

For example, if the cause of the pleural effusion is asbestos-related lung cancer then chemotherapy, radiotherapy and / or immunotherapy may be used to treat the root cause. In cases of pneumonia the doctor will prescribe antibiotics to treat the infection.

To learn more about pleural effusions and their treatment please read:

Mesothelioma UK: Pleural effusion

Cancer Research: Fluid on the lung treatment