Pleural effusion / water in the lungs

Clearly explained!

SHORT & SHORT

Most common causes of pleural effusion

Cancer (tumor, malignoma)
Heart (heart failure, cardiac insufficiency)
Pneumonia (bacterial pneumonia)
Pulmonary embolism

Symptoms of a pleural effusion

Shortness of breath (dyspnea)
Pain/pressure sensation in the chest area
Cough
Water retention in the tissue (edema)
Fever

Synonyms for pleural effusion

Water on the lungs
Water in the lungs (pulmonary edema)
Water accumulation around the lungs
Accumulation of water in the chest

Treatment of a pleural effusion

Puncture (thoracentesis, pleural puncture)
Pleurodesis (thoracic drainage, talc/VATS)
Pleural catheter for drainage

The pleura (pleura)

The pleura (pleura) is a thin, two-leaf skin in the thorax (chest). The inner skin envelops the lungs and is called the visceral pleura (pleura visceralis, pleura pulmonalis). The outer skin, the parietal pleura, lines the inner surface of the chest (thorax). The pleural cavity (cavitas pleuralis) is located between the pleura and the pleura. This space or gap is filled with a few milliliters of fluid (pleural fluid) so that the pleura and pleura adhere to each other during all breathing movements – comparable to two panes of glass with a film of fluid between them. If one skin moves by lifting the rib cage, it automatically pulls the other with it. This creates negative pressure and draws air into the lungs.

Illustration der Lunge mit Rippenfell, Lungenfell und Pleuraspalt bei gesunden Menschen

What is a pleural effusion?

A pleural effusion is an accumulation of fluid in the pleural cavity (chest cavity) that exceeds normal levels. In a healthy person, a few milliliters in the pleural cavity ensure that both pleural leaves can be moved without pain.

In a person suffering from pleural effusion, an excessive amount of fluid accumulates in the pleural cavity. This is the space between the pleura of the fine skin in the chest and the pleura of the fine skin of the lungs. Above a certain level, the effusion impairs breathing, as the fluid takes up space in the lungs and the lungs can no longer fully expand/deflate to absorb oxygen.

What causes a pleural effusion?

The underlying diseases can be many and varied. In a long list of diseases, the most common causes of pleural effusion are cancer (malignancy), heart failure (cardiac insufficiency) or pneumonia. Lung carcinoma, followed by breast carcinoma, is the most common cause of malignant pleural effusion (caused by a malignant tumor).

Illustration der Lunge bei einem Pleuraerguss

“

Draining is very easy with the drainage system. I previously had to go to the emergency room twice to have a puncture, but that is no longer necessary. I panicked every time I ran out of air.

– Mr. H. D. / Pleural effusion –

More patient experiences

What symptoms does a pleural effusion cause?

Shortness of breath (dyspnea), exhaustion (fatigue), nausea and pain.

How is a pleural effusion treated?

It is important to treat the underlying disease. The treatment of a pleural effusion depends on the type of effusion. If, for example, a lot of fluid continues to accumulate in the pleural cavity despite optimal drug therapy, this is referred to as a so-called refractory, recurrent pleural effusion.

Various treatment options are available to treat a pleural effusion:

Pleural puncture

In therapeutic pleural puncture (thoracentesis), the accumulated fluid is removed via a cannula using a syringe. This procedure is usually carried out on an outpatient basis under local anesthesia in a hospital emergency room. Therapeutic puncture is not a definitive therapy, which is why further punctures are often required in hospital as soon as fluid has built up again.

Pleurodesis

Depending on the underlying disease and type of effusion, recurring (recurrent) effusions can be prevented by chemical pleurodesis (intentional adhesion of the lung leaves). For this purpose, a drug (e.g. talc) is sprayed into the pleural cavity via a rigid silicone catheter. The chemical substance is intended to trigger an inflammatory reaction, which leads to the pleural sheets (pleura and lung membrane) sticking together so that water can no longer accumulate. This procedure is often performed surgically under general anesthesia in combination with video-assisted thoracoscopy (VATS). Depending on the course of the procedure, the patient may have to stay in hospital for a few days. In some cases and depending on the underlying disease, a drainova or PleurX™ permanent catheter is also implanted.

Permanent pleural catheter

A thin, soft silicone catheter can be implanted once, under local anesthesia, on an outpatient basis or in conjunction with a short inpatient stay. This enables the person concerned to drain the fluid at home temporarily and independently as required. Repeated punctures in hospital, the clinic or at the doctor’s are no longer necessary after implantation and the symptoms caused by fluid accumulation can be better controlled. In addition, regular drainage of the pleural effusion can lead to spontaneous pleurodesis (adhesion of the pleural cavity).

Find out more about the catheter

The advantages of ewimed drainage systems at a glance:

Efficient symptom control
Fewer hospital stays
No recurring, painful punctures

Safe, simple and time-saving drainage at home
Information on how drainage is performed by a fenik employee at your home
Improving quality of life and mobility

Delivery of the sterile drainage sets prescribed by the doctor by post to your home
Reducing the risk of infection

The ewimed service and care concept

Important note

Since 2018, the European and American medical societies for thoracic surgery and pneumology have also recommended the implantation of a tunneled permanent pleural catheter for drainage in the event of recurrent effusions in order to increase the possibility of pleurodesis (adhesion of the pleural cavity) (sources: Europe USA)