Pleural effusion is an abnormal collection of fluid in the pleural space between the lungs and chest wall. It can occur when fluid builds up faster than it drains away and common causes include congestive heart failure, pneumonia, and cancer. Diagnosis involves chest x-rays, CT scans, or analyzing fluid drawn from the pleural space during a thoracentesis procedure. Treatment depends on the underlying cause but may include diuretics, antibiotics, drainage of fluid, or surgery in severe cases.
Pleural effusion, sometimes referred to as โwater on the lungs,โ is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing.
Normally, the pleural space contains a small amount of fluid (5 to 15 mL), which acts as a lubricant that allows the pleural surfaces to move without friction.
But if fluid builds up from either increased production or inadequate removal pleural effusion results.
Pleural effusion B/L or unilateral (parapneumonic process)
Refers to any significant collection of fluid within pleural space.
Any imbalance in formation, absorption lead accumulation of pleural fluid. Common condition:
CHF
Bacterial pneumonia
Malignancy(chest tumor)
Pulmonary embolism
Pleura effusion is a condition refers to a collection of fluid in the pleural space. It is almost secondary to other conditions.
Pleural effusion, sometimes referred to as โwater on the lungs,โ is the build-up of excess fluid between the layers of the pleura outside the lungs. The pleura are thin membranes that line the lungs and the inside of the chest cavity and act to lubricate and facilitate breathing.
Normally, the pleural space contains a small amount of fluid (5 to 15 mL), which acts as a lubricant that allows the pleural surfaces to move without friction.
But if fluid builds up from either increased production or inadequate removal pleural effusion results.
Pleural effusion B/L or unilateral (parapneumonic process)
Refers to any significant collection of fluid within pleural space.
Any imbalance in formation, absorption lead accumulation of pleural fluid. Common condition:
CHF
Bacterial pneumonia
Malignancy(chest tumor)
Pulmonary embolism
Pleura effusion is a condition refers to a collection of fluid in the pleural space. It is almost secondary to other conditions.
Atelectasis is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Chronic obstructive pulmonary disease (COPD)- Preeti sharmaEducate with smile
ย
COPD is a type of obstructive lung disease and related conditions. it is very helpful presentation to you about information of COPD.
It includes all things that is definition, causes, symptoms, pathophysiology, diagnostic evaluation, types, treatment and role of nurses for COPD patient.
Atelectasis is a complete or partial collapse of the entire lung or area (lobe) of the lung. It occurs when the tiny air sacs (alveoli) within the lung become deflated or possibly filled with alveolar fluid.
Lung abscess is a type of liquefactive necrosis of the lung tissue and formation of cavities (more than 2 cm) containing necrotic debris or fluid caused by microbial infection.
Emphysema is a type of COPD involving damage to the air sacs (alveoli) in the lungs. As a result, your body does not get the oxygen it needs. Emphysema makes it hard to catch your breath. You may also have a chronic cough and have trouble breathing during exercise. The most common cause is cigarette smoking
Chronic obstructive pulmonary disease (COPD)- Preeti sharmaEducate with smile
ย
COPD is a type of obstructive lung disease and related conditions. it is very helpful presentation to you about information of COPD.
It includes all things that is definition, causes, symptoms, pathophysiology, diagnostic evaluation, types, treatment and role of nurses for COPD patient.
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This ๐๐ฅ๐๐ฎ๐ซ๐๐ฅ ๐๐๐๐ฎ๐ฌ๐ข๐จ๐งanimated template is designed by RxSlides, a medical professional team covering the following topics about ๐๐ฅ๐๐ฎ๐ซ๐๐ฅ ๐๐๐๐ฎ๐ฌ๐ข๐จ๐ง
๐๐๐๐ข๐ง๐ข๐ญ๐ข๐จ๐ง:
โข Respiratory illness caused by the buildup of fluid between lung and chest cavity tissue layers.
๐๐ง๐๐ญ๐จ๐ฆ๐ฒ ๐จ๐ ๐ญ๐ก๐ ๐๐ฎ๐ง๐
โข The lung is a vital organ responsible for gas exchange.
โข It is surrounded by two thin membranes called the pleurae.
โข The visceral pleura covers the lung surface.
โข The parietal pleura lines the inner chest wall.
๐ฉ๐ซ๐๐ฏ๐๐ฅ๐๐ง๐๐:
โข ๐๐ฅ๐๐ฎ๐ซ๐๐ฅ ๐๐๐๐ฎ๐ฌ๐ข๐จ๐ง is a common condition, affecting millions of people worldwide.
โข The prevalence varies by region, with higher rates in developing countries
๐๐๐ญ๐ก๐จ๐ฉ๐ก๐ฒ๐ฌ๐ข๐จ๐ฅ๐จ๐ ๐ฒ:
โข Illustrated anatomy of the respiratory system included.
โข Animated illustrations demonstrate fluid formation and maintenance.
โข Parietal and visceral pleura form the pleural space.
โข Fluid produced by filtration from systemic capillaries.
โข Fluid accumulation in the pleural cavity causes Pleural Effusion.
๐๐ข๐ฌ๐ค ๐ ๐๐๐ญ๐จ๐ซ๐ฌ
โข Smoking
โข Heart disease
โข Liver disease
โข Alcohol
โข Lung disease
โข Asbestos exposure
๐๐๐ฎ๐ฌ๐๐ฌ:
๐๐ซ๐๐ง๐ฌ๐ฎ๐๐๐ญ๐ข๐ฏ๐
o Increased systemic/pulmonary capillary pressure and decreased osmotic pressure.
o Major causes: cirrhosis, heart failure, nephrotic syndrome, protein-losing enteropathy.
๐๐ฑ๐ฎ๐๐๐ญ๐ข๐ฏ๐:
o Local processes leading to increased capillary permeability.
o Fluid, protein, cells, and serum constituents exude.
o Major causes: inflammation, infection, lung injury, tumors, lung cancer, rheumatoid arthritis, pneumonia, tuberculosis, surgical damage, lymphatic fluid accumulation.
๐๐ฒ๐ฆ๐ฉ๐ญ๐จ๐ฆ๐ฌ:
โข Dyspnea (shortness of breath)
โข Labored breathing
โข Non-productive cough
โข Chest tightness
โข Orthopnea (difficulty breathing lying down)
๐๐ข๐๐ ๐ง๐จ๐ฌ๐ญ๐ข๐ ๐ฆ๐๐ญ๐ก๐จ๐๐ฌ
โข Physical examination
โข Chest radiographs
โข Imaging
๐๐ซ๐๐๐ญ๐ฆ๐๐ง๐ญ ๐๐ฉ๐ญ๐ข๐จ๐ง๐ฌ:
Thoracentesis (fluid removal)
Catheter drainage
Pleurodesis (scarring of pleural space)
Pleuroperitoneal shunt (fluid drainage to abdomen)
Pleurectomy (surgical removal of pleura)
Thoracoscopy (visual examination of pleural space)
Thoracostomy (surgical opening of chest cavity)
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Abnormal fluid accumulation in potential space in between parietal and visceral pleurae โ there is imbalance between formation and absorption in response to injury, inflammation or both locally and systematically
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
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i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganongโs Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
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This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
ย
RESULTS: Overall life span (LS) was 2252.1ยฑ1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years โ 64.8%, 20 years โ 42.5%. 513 LCP lived more than 5 years (LS=3124.6ยฑ1525.6 days), 148 LCP โ more than 10 years (LS=5054.4ยฑ1504.1 days).199 LCP died because of LC (LS=562.7ยฑ374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0โN12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0โN12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
5. INTRODUCTION
The body produces pleural fluid in
small amounts to lubricate the
surfaces of the pleura, it lines the
chest cavity and surrounds the lungs.
The pleural cavity contains a
relatively small amount of fluid,
approximately 10 ml on each side .
Excessive Accumulation of fluid in the
pleura
6. โข PLEURAL EFFUSION is an abnormal,
excessive collection of this fluid .
Excessive amounts of such fluid can
impair breathing by limiting the
expansion of the lungs during
respiration
According to Javed ansari
7. โข Pleural effusion, sometimes referred to
as โwater on the lungs,โ is the build-up
of excess fluid between the layers of
the pleura outside the lungs.
The pleura are thin membranes that
line the lungs and the inside of the
chest cavity and act to lubricate and
facilitate breathing.
Brunner and Suddarthโs
8. Conโฆโฆโฆโฆโฆโฆโฆโฆโฆโฆโฆโฆ..
โข Pleural effusion is define as Build up of
excess fluid between the layers of the
pleura outside the lungs.
Lippincott
โข pleural effusion refers to a collection of
fluid in the pleural space
โข luckmaan
10. Types of Effusions
TRANSUDATIVE PLEURAL
EFFUSIONS
It caused by fluid leaking into the pleural
space. This is caused by increased
pressure in, or low protein content in, the
blood vessels . A transudate is a clear
fluid, similar to blood serum . It reflect a
systemic disturbance of body
12. โข ATELECTASIS
โข is the collapse or closure of a lung resulting
in reduced or absent gas exchange.
โข CIRROSIS
โข Hepatic Hydrothorax (Pleural
Effusion) Pleural effusions complicate end-
stage liver disease in 5% of
patients. Effusions (defined as 500 mL or
more of fluid within the pleural space) are
typically right-sided. No
cardiopulmonary cause for the pleural
effusion is found.
13. โข Congestive heart failure
โข (ineffective pumping of blood
through the circulatory system due
to enlargement and weakening of
the heart muscle) is the most
common cause of pleural effusion.
Pneumonia is a common lung
infection and may result in pleural
effusion.
14. โข Hypoalbuminemia
is a medical sign in which the level of
albumin in the blood is abnormally
low.
Nephrotic syndrome
If there are too much protein losing
from patientโs blood vessel, he will
have more severe edema,
Hypoalbuminemia in NS can cause a decrease in
oncotic pressure causing extravasation (leakage )
of fluid into the interstitial space. In conditions of
severe hypoalbuminemia, fluid extravasation may
cause occurrence of pleural effusion.
15. Peritoneal dialysis
โข complications in PD patients
and result from the migration
of dialysis fluid under pressure
from the peritoneal cavity into
the pleural space..
16. Types Of Effusions cont..
EXUDATIVE EFFUSIONS
A fluid rich in protein and cellular
elements that oozes ( leaking) out of
blood vessels due to inflammation . It is
caused by blocked blood vessels,
inflammation, lung injury, and drug
reactions. An exudateโwhich often is a
cloudy fluid, containing cells and much
protein .
17. Causes of Exudates:
โข Atelectesis โ
collapse of both lungs
Hemothorax Infection
โข (bacteria, viruses, fungi, tuberculosis, or
parasites)
Uremia
โข fluid, electrolyte, and hormone
imbalances and metabolic
abnormalities,
18. Asbestos exposure
โข These diseases can lead to irritation,
swelling and inflammation, which in
causes the blood vessels in the pleurae
to leak extra fluid into the pleural space.
Pulmonary embolism
is a blockage in one of
the pulmonary arteries in your lungs. In
most cases, pulmonary embolism is
caused by blood clots that travel to the
lungs from the legs
19.
20. Pathophysiology
Due to etiological factors
It is explained by increased pleural fluid
formation or decreased pleural fluid
absorption
Increased pleural fluid formation can result
from elevation of hydrostatic pressure
(increasing weight of fluid ) & decreased
osmotic pressure.
21. It leads to increased capillary permeability
( capacity of a blood vessel wall to allow
for the flow of small molecules (drugs,
nutrients, water, ions) or even whole cells
& passage of fluid is through openings in
the diaphragm
Hence production increases & absorption
is decreases lymphatic obstruction
Pleural effusions produce a restrictive
ventilatory defect and also decrease the
total lung capacity and vital capacity
22.
23. CLINICAL MANIFESTATION
Pleuritic chest pain indicates
inflammation of the parietal pleura
Physical examination findings that can
reveal the presence of an effusion dull
or flat note on percussion
diminished or absent breath sounds on
auscultation. Chest pain, usually a
sharp pain that is worse with cough or
deep breaths, Cough, Fever, Rapid
breathing, Shortness of breath
24. DIAGNOSTIC EVALUATION
During a physical examination, the doctor
will listen to the sound of your breathing
with a stethoscope and may top on your
chest to listen for dullness. The following
tests may help to confirm a diagnosis :
Chest CT scan Chest x-ray Pleural fluid
analysis (examining the fluid under a
microscope to look for bacteria, amount
of protein, and presence of cancer cells)
Thoracentesis (a sample of fluid is
removed with a needle inserted between
the ribs) Ultrasound of the chest
25. โข Chest Radiography :The posteroanterior
and lateral chest radiographs are still the
most important initial tools in diagnosing
a pleural effusion.
โข Ultrasound is useful both as a diagnostic
tool and as an aid in performing
thoracentesis. It assist in identifying
pleural fluid loculations.
โข Computed Tomography: Cross-sectional
computed tomography (CT) It helps
distinguish anatomic compartments more
clearly This modality is useful as well in
distinguishing empyema
28. โข Treatment depends on the cause of
your pleural effusion and how bad
your symptoms are. You may need
any of the following:
โข Diuretics laxis may help you lose
extra fluid caused by heart failure or
other problems.
โข Antibiotics help prevent or treat an
infection caused by bacteria.
โข Analgesic drug to relief pain
29. โข NSAIDs help decrease swelling and
pain or fever..
โข Steroids or other types of medicines
may be given to decrease swelling.
โข Drainage of extra pleural fluid may be
done using thoracentesis or a chest
tube. A chest tube may stay in your
chest for days or weeks. This allows the
extra fluid around your lungs to drain
over time. You may need medicines put
directly into your chest if the fluid does
not drain out easily.
30. SURGICAL PROCEDURE
In some cases, the following may be
done: Surgery
โข Thoracentasis Pleural fluid is drawn
out of the pleural space in a process
called thoracentesis. A needle is
inserted through the back of the chest
wall in the sixth, seventh, or eighth
intercostal space into the pleural
space. The fluid may then be
evaluated.
โข Gram stain and culture to identify
31. Nursing Diagnosis
&
Nursing Intervention
โข 1. Ineffective breathing pattern related to
decreased lung expansion(accumulation
of liquid), as evidenced by dyspnea,
changes in depth of breathing, accessory
muscle use.
Interventions
โข Maintain a comfortable position is
usually elevated headboard
โข Given oxygen through a cannula (8mls)
32. 2. Acute Pain related to accumulation of
fluid in the pleural space and rubbing of
thoracostomy tube to the lungs
โข Interventions
โข -The presence of pain, the scale and
intensity of pain was well assessed
โข -The client taught about pain
management and relaxation with
distraction
โข -Chest tube secured to restrict
movement and avoid irritation
โข -Given prescribed analgesics i.e
diclofenac 75mg.
33. 3. Risk for nutrition impariment, less than
body requirement related to inability to
ingest adequate nutrients
Interventions
โข -Patient relative i.e his father encouraged
to give him energy reaching food stuff
together with energy supplement so that
he can get enough energy.
โข -Administer DNS as prescribed to the
patient to increase energy lost.
34. 4. Risk for fluid volume deficit related to
chest tube drainage.
โข Interventions
โข -encourage the patient to drink
enough water to supplement the one
lost by chest tube drainage
โข -IV fluids & DNS to replace fluid lost in
drainage system monitored in
24hours.
35. 5. Risk for infection related to the
presence of fluid in the pleural space
and the incision site.
โข Interventions
โข -The patient dressed at the incision
site when it is wetted, probably after 2
to 3 days
โข -Given antibiotics as prescribed i.e IV
metronidazole 500mg 8 hourly, IV
ceftiaxone 1gm.
36. Possible Complications
A lung that is surrounded by excess
fluid for a long time may be
damaged. Pleural fluid that becomes
infected may turn into an abscess,
called an empyema, which will need
to be drained with a chest tube.
Pneumothorax (air in the chest
cavity) can be a complication of the
thoracentesis procedure.