Pleural fluid volume estimation: A chest radiograph prediction rule

Blackmore, C. Craig; Black, William C.; Dallas, Robert V.; Crow, Harte C.

doi:10.1016/s1076-6332(05)80373-3

Cited by 160 publications

(87 citation statements)

References 12 publications

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“…Although some early consolidation must be localized below the pleura and can be imaged using ultrasound. Current literature suggests that concolidation may be below the pleura (9).…”

Section: Discussionmentioning

confidence: 99%

A New Tool in the Examination of Lungs in the Emergency Department: Lung Ultrasound

Evrın¹,

Katipoğlu²,

Szarpak³

et al. 2017

EAJEM

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“…Although some early consolidation must be localized below the pleura and can be imaged using ultrasound. Current literature suggests that concolidation may be below the pleura (9).…”

Section: Discussionmentioning

confidence: 99%

A New Tool in the Examination of Lungs in the Emergency Department: Lung Ultrasound

Evrın¹,

Katipoğlu²,

Szarpak³

et al. 2017

EAJEM

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“…Pleural effusion becomes visible on the upright lateral radiograph at a volume of approximately 50 ml as a meniscus in the posterior costophrenic sulcus. The meniscus becomes visible on the postero-anterior projection at a volume about 175 to 525 ml (Woodring, 1984) or 200 ml (Blackmore et al, 1996). To determine the accuracy of chest ultrasound for detecting pleural effusion in acutely decompensated heart failure patients, previous study evaluated the usefulness of chest ultrasound in comparison with physical signs, erect postero-anterior chest x-ray, and thoracic x-ray computed tomography (Kataoka & Takada, 2000).…”

Section: Accuracy Of Sonographic Detection Of Pleural Effusionmentioning

confidence: 99%

Clinical Utility of Ultrasonographic Detection of Pleural Effusion for Evaluation of Heart Failure Patients

Kataoka¹

2012

Sonography

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“…5 • pleural fluid LDH/serum LDH >0. 6 • pleural fluid LDH more than two-thirds of the upper limit of normal serum LDH Unilateral effusions require further assessment. The initial investigation of choice is diagnostic pleural aspiration.…”

Section: Initial Diagnostic Approachmentioning

confidence: 99%

“…About 200 ml of pleural fluid must be present before any change is evident on the plain posteroanterior (PA) chest radiograph. 6 The classical appearance of pleural effusion is easily recognised. However, loculated fluid may appear atypically and encysted fluid within the lung fissure may give the appearance of an intraparenchymal mass (Fig 1).…”

Section: Radiological Investigationsmentioning

confidence: 99%

Investigation of the patient with pleural effusion

Rahman

Munavvar

2009

Clinical Medicine

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Pleural effusion is a common clinical problem and may present to a wide range of specialties. Accurate aetiological diagnosis is key to subsequent management, requiring a multidisciplinary approach and knowledge of the correct investigation pathway. This article will focus on appropriate staged investigations for the patient presenting with pleural effusion rather than on its causes or treatment. Clinical syndromesPleural effusion is often detected on plain chest radiography as an incidental finding and patients may be asymptomatic. Clinical symptoms are variable, depending on the size and aetiology of the effusion and rarely specific enough to suggest a diagnosis in the absence of further investigations. Large effusions are likely to be associated with dyspnoea, but this is often a late finding and oxygen saturations may not be severely lowered. Dyspnoea is the result of impaired mechanics and increased intrapleural pressure swings.The presence of chest pain implies involvement of the parietal pleura which is heavily innervated. Inflammation, infection and malignant involvement may produce pain, including shoulder tip symptoms associated with diaphragmatic involvement. Weight loss, anorexia and malaise may imply malignancy or infection (eg empyema). CausesPleural effusions are divided into transudative and exudative (Table 1). They are diagnosed according to pleural fluid biochemical characteristics (see below). However, transudates occur with structurally normal pleura, in which oncotic or hydrostatic pressure results in fluid leak. In contrast, exudates occur with damaged or altered pleura, resulting in loss of tissue fluid and protein causing fluid formation. 1 Differentiation of transudate from exudate is key to further management. Treatment for transudative effusion relies on treatment of the underlying disease, and uncommonly requires specific pleural intervention. In contrast, exudative effusion usually needs further investigation and often requires intervention. Initial diagnostic approachThe presence of bilateral, symmetrical effusions in the appropriate clinical context is highly suggestive of transudative effusion, and in general requires no further investigation. 2 However, it should be noted that about 50% of heart failure CME Respiratory medicine • pleural fluid protein/serum protein >0.5• pleural fluid LDH/serum LDH >0.6• pleural fluid LDH more than two-thirds of the upper limit of normal serum LDH * If pleural fluid protein is 25-35 g/l or serum protein level is abnormal, apply Light's criteria. LDH = lactate dehydrogenase; TB = tuberculosis.

show abstract

Pleural fluid volume estimation: A chest radiograph prediction rule

Cited by 160 publications

References 12 publications

A New Tool in the Examination of Lungs in the Emergency Department: Lung Ultrasound

A New Tool in the Examination of Lungs in the Emergency Department: Lung Ultrasound

Clinical Utility of Ultrasonographic Detection of Pleural Effusion for Evaluation of Heart Failure Patients

Investigation of the patient with pleural effusion

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