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  • Pleural Effusion Algorithm 1907f

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    nuramirah abdulwahab
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    This document provides an algorithm for investigating unilateral pleural effusions. The algorithm involves: 1) Determining if the clinical picture suggests a transudate or exudate. 2) Performing pleural aspiration with ultrasound guidance and analyzing the fluid. 3) If not a transudate, considering whether the fluid analysis and clinical features provide a diagnosis. If not, further imaging or procedures may be required.

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    This document provides an algorithm for investigating unilateral pleural effusions. The algorithm involves: 1) Determining if the clinical picture suggests a transudate or exudate. 2) Performing pleural aspiration with ultrasound guidance and analyzing the fluid. 3) If not a transudate, considering whether the fluid analysis and clinical features provide a diagnosis. If not, further imaging or procedures may be required.

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    © All Rights Reserved
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    Download as pdf or txt
    17 views1 page

    Pleural Effusion Algorithm 1907f

    Uploaded by

    nuramirah abdulwahab
    This document provides an algorithm for investigating unilateral pleural effusions. The algorithm involves: 1) Determining if the clinical picture suggests a transudate or exudate. 2) Performing pleural aspiration with ultrasound guidance and analyzing the fluid. 3) If not a transudate, considering whether the fluid analysis and clinical features provide a diagnosis. If not, further imaging or procedures may be required.

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    © All Rights Reserved
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    of 1

    Investigation of unilateral pleural effusion

    Algorithm adapted by permission from BMJ Publishing


    Group Limited. Thorax, Hooper C, Lee YCG, Maskell N
    on behalf of the BTS Pleural Disease Guideline Group,
    65 (Suppl 2): ii14-ii7, 2010). *Record initial appearance of fluid
    (e.g. straw coloured, turbid, blood
    History, clinical examination and CXR stained).

    Does the clinical picture suggest a transudate? E.g. LVF, YES


    hypoalbuminaemia, dialysis

    NO Treat the cause

    Refer to chest physician Resolved?

    * Pleural aspiration (with ultrasound guidance). NO YES


    Send for cytology, protein, LDH, pH, Gram stain, culture
    and sensitivity.
    STOP

    Is it a transudate? YES

    NO Treat the cause

    Has the fluid analysis and clinical features given a


    YES
    diagnosis?

    NO Treat appropriately

    Request contrast enhanced CT thorax

    Consider LA thorascopy or surgical Consider radiological guided pleural biopsy +/-


    VATS chest tube drainage if symptomatic

    Cause found? YES

    NO

    Re-consider treatable conditions such as PE, TB, Treat appropriately


    chronic heart failure and lymphoma. Watchful waiting
    often appropriate.

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