PATHOSCHEMA® Immersive Experience (PIE) | Pleural Effusion ⛶ Expand Experience Parietal Pleura (Chest Wall) Visceral Pleura (Lung) Pleural Space (10-20ml Fluid) Systemic Capillaries Parietal Lymphatic Stomata Hydrostatic & Oncotic Balance Starling forces maintain micro-volume. 1. Balanced State 2. Transudative 3. Exudative Equilibrium: Fluid Entry = Fluid Exit Transudate: High Hydrostatic Pressure (e.g., Heart Failure) Pressure Surge Exudate: Capillary Leak & Blocked Drainage (e.g., Malignancy/Infection) Lymph Blocked High Permeability Pleuritic Chest Pain Sharp pain on inspiration Stony Dullness & Decreased Breath Sounds Tracheal Deviation (Away) Indicates massive effusion pushing mediastinum 1. Chest X-Ray (CXR) 2. Thoracic Ultrasound 3. Diagnostic Tap 4. Light's Criteria PA Chest Radiograph Homogeneous opacity with Meniscus Sign Meniscus Bedside Thoracic US Black (Anechoic) Fluid Collection Ultrasound-Guided Aspiration Safely obtains fluid for biochemistry/cytology Light's Criteria (Exudate if 1+ met): Pleural/Serum Protein > 0.5 Pleural/Serum LDH > 0.6 Pleural LDH > 2/3 upper limit normal I. Treat Underlying II. Thoracentesis III. Chest Drain IV. Pleurodesis Systemic Diuretics (e.g. Furosemide for Heart Failure) Resolves transudates without invasive procedures. Therapeutic Thoracentesis Aspirates fluid for immediate symptomatic relief. Intercostal Chest Drain (ICD) Continuous drainage via underwater seal (for Empyema/Massive effusions). Chemical Pleurodesis (e.g. Sterile Talc) Induces inflammation to permanently fuse pleural layers (Malignancy). Clinical Evidence Mastery Question 1 of 10 Score: 0 Loading... 1. Physiology 2. Pathophysiology 3. Symptoms 4. Investigations 5. Management 6. Mastery
