How is pleural effusion treated?
Treatment of pleural effusion focuses on getting the excess fluid out and keeping it from collecting again. Providers choose pleural effusion treatment based on the underlying condition and whether the effusion is making it hard for you to breathe.
Medicines
Providers use diuretics and other heart failure medications to treat pleural effusion from congestive heart failure or other medical causes. Some people need antibiotics. For a malignant effusion, you may also need treatment with chemotherapy, radiation therapy or a medication infusion within your chest.
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Procedures
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A provider can use therapeutic thoracentesis or a chest tube to drain a pleural effusion that’s causing respiratory symptoms.
Even with drainage, you may have pleural effusions that are hard to control or that come back due to a malignancy. In this case, a provider puts a sclerosing agent (a type of drug that purposely creates scarring) into your pleural cavity through a chest tube. This causes fibrosis (excessive fibrous tissue) of the pleura (pleural sclerosis). This is 50% successful in preventing pleural effusions from happening again.
Surgery
You may need surgery if drainage or pleural sclerosis don’t work. Your surgeon will carefully evaluate you and discuss the possible risks and benefits of surgical pleural effusion treatments.
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The two types of surgery include:
- Video-assisted thoracoscopic surgery (VATS). This minimally invasive approach uses one to three small (half-inch) incisions (cuts) in your chest. VATS can manage pleural effusions that are difficult to drain or that come back because of a tumor. A provider can insert sterile talc or an antibiotic during surgery to prevent fluid from building up again.
- Thoracotomy (traditional, “open” thoracic surgery). A surgeon performs a thoracotomy through a 6-inch to 8-inch incision in your chest. They use this approach when you have an infection. A thoracotomy removes all of the fibrous tissue and helps clear out the infection from the pleural space. You’ll need chest tubes for two days to two weeks after surgery to keep draining fluid.
Complications/side effects of the treatment
Complications of treatment may include:
- Pulmonary edema.
- Blood clots.
- Abnormal heart rhythms.
- Pneumothorax (collapsed lung).
How long does it take to recover from this treatment?
You may need to take it easy for two days after a thoracentesis. If you have VATS, you may need to spend a few days in the hospital afterward. After a thoracotomy (open surgery), you’ll probably be in the hospital for a week.
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