Clinical and Etiological Profile of an Exudative Pleural Effusion in a Tertiary Care Center

Abstract

Pleural effusion results from either excess fluid accumulation in pleural space or decreased absorption by pleural lymphatics. ormally, 0.13 mL/kg of body weight of fluid is present in pleural space. This small amount of fluid acts as a lubricant to allow the smooth sliding of parietal and visceral pleura during respiration. Normal amount of fluid is maintained by the balance between hydrostatic, oncotic pressure of pleural capillaries and intrapleural pressure, oncotic pressure of pleural fluid. Any imbalance of the above mechanism will lead to excess fluid accumulation in pleural space. Pleural effusions were either transudative or exudative, Light's criteria Pleural fluid is exudative if it meets any one of the following criteria-pleural fluid protein/serum protein ratio >0.5 or pleural fluid lactate dehydrogenase (LDH)/serum LDH ratio >0.6 or pleural fluid LDH level greater than two-thirds the upper limit. Congestive heart failure is the most common condition that produce transudative pleural effusion followed by hepatic hydrothorax. Nephrotic syndrome, hypoproteinemia are some other common causes. Common causes of exudative effusion include tuberculosis, parapneumonic effusion, viral infections, and malignancy.