Last week we spoke about the large number of patients we have seen recently with fluid in the chest, called pleural effusion or just “effusion” for short. Knowing if this fluid is associated with inflammation or not helps determine the treatment strategy for the patient. Removing a sample of the fluid for analysis is an important first step. This procedure, called a thoracentesis, can usually be done in the office.
Patients with fluid that is not associated with inflammation usually have an underlying benign disease such as heart or kidney failure. These patients are usually treated with medication unless the amount of fluid is so large that it compromises their breathing. We can follow the chest x-rays of these patients to look for improvement. A patient who has fluid in the chest associated with inflammation needs more aggressive attention since that fluid will not resolve without more specialized and invasive help. This is the type of fluid that is associated with severe infections and tumor, along with some other inflammatory diseases.
Treatment for these patients may involve placing a large bore chest tube into the chest to allow for total drainage. Occasionally, a surgical procedure, called thoracoscopy, is needed to remove the fluid and instill medication to prevent further fluid accumulation.
As with all treatments, having an accurate diagnosis is essential. If you have fluid in the chest, do not let it linger without a proper diagnosis.