Treatment and Approach to Pleural Effusion Medical condition скачать в хорошем качестве

Treatment and Approach to Pleural Effusion Medical condition

treatment and clinical approach to pleural effusion, based on current best practices and expert guidelines: 🩺 Approach to Pleural Effusion A systematic approach helps identify the underlying cause and guide appropriate treatment. 🔍 Step-by-Step Diagnostic Approach: History & Physical Examination Symptoms: Dyspnea, pleuritic chest pain, cough Risk factors: Heart failure, cancer, TB, liver/kidney disease Imaging Chest X-ray: Detects moderate to large effusions Ultrasound: More sensitive; guides thoracentesis CT scan: Useful for complex or loculated effusions Thoracentesis Diagnostic fluid aspiration Analyze for: Protein, LDH (Light’s criteria) Cell count, pH, glucose Cytology, Gram stain, AFB, culture ADA (for TB), amylase, triglycerides Classify the Effusion Transudate: Due to systemic factors (e.g., heart failure, cirrhosis) Exudate: Due to local pathology (e.g., infection, malignancy, TB) 📘 Source: AAFP Diagnostic Approach 💊 Treatment of Pleural Effusion Treatment depends on the type and underlying cause of the effusion: 🔹 Transudative Effusions: Heart failure: Diuretics (e.g., furosemide), treat underlying cardiac condition Cirrhosis: Salt restriction, diuretics, TIPS for refractory cases Nephrotic syndrome: Manage proteinuria and fluid overload 🔹 Exudative Effusions: Parapneumonic effusion/empyema: Antibiotics Chest tube drainage if complicated Intrapleural fibrinolytics or thoracoscopy if loculated Tuberculous effusion: Anti-TB therapy (6-month regimen) Corticosteroids in select cases Malignant effusion: Therapeutic thoracentesis for symptom relief Indwelling pleural catheter or talc pleurodesis for recurrent effusions Oncologic treatment (chemotherapy, radiation) Chylothorax: Low-fat diet with medium-chain triglycerides Octreotide or surgical ligation if persistent #pleuraleffusion