Diagnostic approach of the patient with pleural effusion

Autores: Santes Óscar, Morales Maza Jesús

Resumen

Pleural effusion (PE) is an excess of fluid in the pleural cavity, resulting from an imbalance between its production, absorption, or both. It is a common pathology, although its causes and incidence depend on the population studied. It is estimated that pleural disorders affect more than 3000 people per million inhabitants1. Although numerous potential causes of PE have been reported, in clinical practice, only a few represent the majority of cases. For example, in a study of more than 3000 patients with PE undergoing diagnostic thoracentesis, the four main causes were cancer (27%), heart failure (HF) (21%), pneumonia (19%), and tuberculosis (9%)2. However, HF could be considered the first cause of PE since most patients with a clinical diagnosis of HF do not undergo thoracentesis. The lack of good-quality randomized clinical trials and the existence of few evidence-based guidelines result in a heterogeneous approach and management of PE. The establishment of the exact etiology of a PE should ideally follow a logical and simple diagnostic algorithm. The key elements to determine the causes of a PE are the clinical evaluation, imaging studies, pleural fluid analysis and when appropriate, pleural biopsy. This review describes the stages in the investigation of PE etiology.

Palabras clave: Pleural effusion diagnosis pleural fluid analysis.

2018-08-14   |   342 visitas   |   Evalua este artículo 0 valoraciones

Vol. 11 Núm.2. Abril-Junio 2018 Pags. 73-78 Hosp Medicin Clinic Manag 2018; 11(2)