The use of thrombolytics in the management of complex pleural fluid collections

Background. There are no available literatures on massive pleural effusions (MPE) in our country.Aim. To determine the aetiology of MPE and compare the mortality rate between malignant and nonmalignant MPE in adult Nigerians.Methods. A prospective study of all the patients diagnosed with nontraumatic pleural fluid collections for one year in two tertiary federal hospitals in Southern Nigeria. A total of 101 consecutive patients with pleural fluid collections were studied. Diagnoses were made by clinical features and laboratory and radiological investigations.Results. Forty-eight patients (47.5%) had MPE with a mean age of 43 years ± 14.04 and 35 were females. Thirty patients (62.5%) were diagnosed with nonmalignant conditions (21 from pulmonary tuberculosis (PTB) and 9 from other causes). Haemorrhagic pleural collections were from malignancy in 12 (30.8%) and from PTB in 6 (15.4%). Straw-coloured collections were from malignancy in 9 (23.1%), from PTB in 8 (20.1%), and from posttraumatic exudative effusion in 3 (7.7%). Compared with nonmalignant MPE, patients with malignant collections had higher mortality within 6 months (8/18 versus 0/30 with aPvalue of 0.000).Conclusion. The presentation of patients with nontraumatic haemorrhagic or straw-coloured MPE narrows the diagnosis to PTB and malignancy with MPE cases being a marker for short survival rate.

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Vanishing pleural fluid collections in cardiac failure simulating lung tumours

Australasian Radiology ◽

10.1111/j.1440-1673.1994.tb00143.x ◽

1994 ◽

Vol 38 (2) ◽

pp. 93-96 ◽

Cited By ~ 4

Author(s):

W F C VAN GELDEREN

Keyword(s):

Pleural Fluid ◽

Cardiac Failure ◽

Lung Tumours ◽

Fluid Collections

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Challenges in Image-Guided Drainage of Infected Pleural Collections: A Review

Journal of Clinical Interventional Radiology ISVIR ◽

10.1055/s-0041-1734374 ◽

2021 ◽

Author(s):

Ashu S. Bhalla ◽

Manisha Jana ◽

Priyanka Naranje ◽

Swish K. Singh ◽

Irshad Banday

Keyword(s):

Pleural Fluid ◽

Fibrinolytic Therapy ◽

Early Initiation ◽

Image Guided ◽

Therapeutic Drugs ◽

Pleural Fibrosis ◽

Route Management ◽

Vital Component ◽

Fluid Collections ◽

Hematogenous Route

AbstractInfected pleural fluid collections (IPFCs) commonly occur as a part of bacterial, fungal, or tubercular pneumonia or due to involvement of pleura through hematogenous route. Management requires early initiation of therapeutic drugs, as well as complete drainage of the fluid, to relieve patients’ symptoms and prevent pleural fibrosis. Image-guided drainage plays an important role in achieving these goals and improving outcomes. Intrapleural fibrinolytic therapy (IPFT) is also a vital component of the management. The concepts of image-guided drainage procedures, IPFT, and nonexpanding lung are discussed in this review.

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Iatrogenic causes of large pleural fluid collections in the premature infant: ultrasonic and radiographic findings

Pediatric Radiology ◽

10.1007/bf02388084 ◽

1987 ◽

Vol 17 (2) ◽

pp. 104-108 ◽

Cited By ~ 7

Author(s):

J. Amodio ◽

S. Abramson ◽

W. Berdon ◽

C. Stolar ◽

R. Markowitz ◽

...

Keyword(s):

Premature Infant ◽

Pleural Fluid ◽

Radiographic Findings ◽

Fluid Collections

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Thoracostomy Tubes and Mediastinal Drains

Chest Imaging ◽

10.1093/med/9780199858064.003.0010 ◽

2019 ◽

pp. 53-58

Author(s):

Tyler H. Ternes

Keyword(s):

Pleural Fluid ◽

Medical Devices ◽

Pleural Space ◽

Tube Placement ◽

Seldinger Technique ◽

Clinical Scenario ◽

Pleural Drainage ◽

Thoracostomy Tube ◽

Broad Term ◽

Fluid Collections

The Thoracostomy and Mediastinal Drains chapter addresses a group of medical devices used to drain intrathoracic collections of fluid or air. A chest (thoracostomy) tube is a broad term used for a variety of hollow catheters used for pleural drainage. Occasionally, the drain is placed in the mediastinum, and in these instances the term mediastinal drain is preferred. Thoracostomy tubes are typically placed in the pleural space for treatment of pneumothorax or pleural fluid. Tube sizes range from 6F to 40F, depending on the clinical scenario. Small catheters are often placed with Seldinger technique, whereas larger tubes are usually placed with blunt dissection. The tube is typically directed towards the apex in the setting of pneumothorax and towards the posterior base for treatment of pleural fluid collections. When interpreting radiographs following chest tube placement, the radiologist should ensure that the tube and sideport are positioned within the pleural space or the desired anatomic location. It is also imperative to exclude intraparenchymal or intrafissural tube placement and tube kinking.

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