Causes Of Pleural Effusion

There are many causes of pleural effusions, such as pneumonia, renal failure, and malignancy. Medications can also cause pleural effusions, such as amiodarone. Because of the vast number of causes for this pathology, one should collect a history from the patient to guide the diagnostic and treatment process. If the patient is unable to provide a history, then one can perform the diagnostics and treat the pleural effusion, but the effusion may return if the root cause of the effusion has not been addressed. Obtaining a chest x-ray is one of the first diagnostics one can order, followed by computed tomography and ultrasound of the chest to discover pleural effusions (Saguil, Wyrick, & Hallgren, 2014). Because pneumonia can cause these presenting …show more content…
Because of ultrasound technology, this needle-aspiration can be guided to reduce the risk of complications associated with thoracenteses. However, the risks have not been completed eliminated. The complications from a thoracentesis include the following: pneumothorax, re-expansion pulmonary edema, which can occur when draining over one liter of fluid from the pleura, abdominal viscus injury, infection, and vagal reactions. Abdominal viscus injuries have been reduced due to ultrasound technology (Sikora, Perera, Mailhot, & Mandavia, 2012). Pneumothoraxes, such as the life-threatening tension pneumothorax, can still occur. According to Rehman et al. (2015), needle gauge can impact the rate of pneumothorax secondary to ultrasound-guided thoracentesis. Using a 16-gauge needle had a statistically significant higher risk of pneumothorax than compared to an 18-gauge needle (p=0.02). However, despite using an 18-gauge needle, some patients still developed pneumothoraxes (Rehman et al., 2015). This can be due to the patient’s comorbidities and other variables. Nonetheless, better practices to reduce patient harm should include the use of a smaller gauge needle, like the 18-gauge needle, and the use of ultrasound to guide the