Pleural fluid is produced by the body in small amounts to lubricate the pleura, the thin layers of tissue that line the chest cavity and surround the lungs. This fluid lubricates the chest cavity and facilitates breathing. When the tissue is irritated or infected, an excessive buildup of fluid develops known as pleural effusion or “water on the lungs.” Medical conditions including congestive heart failure, certain types of cancer, pneumonia and tuberculosis can cause pleural effusion. Fluid may also build up following radiation therapy or chemotherapy.
Board-certified pulmonologists and thoracic surgeons at the Brigham and Women’s Hospital (BWH) Lung Center provide comprehensive, specialized care for patients experiencing pleural effusion. Their expertise and collaboration with other specialists throughout BWH provide patients with a highly informed diagnosis and a cohesive treatment plan. Should surgery or a procedure be required, our surgeons and interventional pulmonologists are experts in the latest minimally invasive thoracic techniques such as ultrasound-guided thoracentesis and video-assisted thoracic surgery (VATS), a safe and effective alternative to open surgery.
Pleural effusion is the result of inflammation and infection, often due to complications from heart and lung diseases and conditions. Some causes of pleural effusion include:
Signs and symptoms of pleural effusion include:
The Lung Center may conduct the following diagnostic tests and procedures:
Treatment for pleural effusion depends on its underlying cause and severity. Sometimes only observation is required, while the majority of cases require medication and/or minimally invasive surgical procedures to remove fluid from the lungs to improve your breathing.
Often an ultrasound-guided thoracentesis can be performed by an interventional pulmonologist to relieve the symptoms of shortness of breath. Open surgery for pleural effusion is rarely done at BWH, having been replaced by telescopic procedures.
A multidisciplinary team will work with you every step of the way, from diagnostics through evaluation, to create a cohesive and comprehensive treatment plan. Our unique approach features same day consultations with multiple specialists and fosters seamless, expert care. Your medical condition will be closely monitored and managed to promote optimal lung functioning and an improved quality of life.
If you require surgery, you will meet with your healthcare team first for pre-operative information and tests. On the day of your surgery, you will receive care from thoracic surgeons, interventional pulmonologists, anesthesiologists and nurses who specialize in surgery for patients with thoracic problems.
After surgery you will go to the recovery room (Post Anesthesia Care Unit-PACU) and then you will be transferred to the Thoracic Intermediate Care Unit (TICU) where you will receive specialized comprehensive care by an experienced medical and nursing staff to get you better rapidly. In many cases, surgery for pleural effusions is day surgery so you may be discharged home after recovery in the PACU with a clear treatment and support plan.
Pleural effusion patients benefit from the wide range of specialists at The Lung Center, including thoracic surgeons, pulmonologists and imaging experts. This collaboration ensures comprehensive diagnosis and targeted treatment for patients.
Any recommended surgery or procedure will be performed by an experienced, board-certified surgeon, in collaboration with the treatment team including nurses and physician assistants, all of whom specialize in taking care of patients with pleural effusion.
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