ABSTRACT
Normal physiology 50 Pleural fluid production 50 Pleural fluid absorption 52
Pathophysiology 53 General considerations 53 An increase in entry rate alone? 53 A decrease in exit rate alone? 54 An increase in entry rate plus a
decrease in exit rate 54
Increases in the entry of pleural fluid 54 Decreases in the exit of pleural fluid 55
Specific examples of diseases leading to effusions 55 Congestive heart failure 55 Malignancy 57 Parapneumonic effusion 57 Tuberculous pleurisy 57
References 57
e major function of the pleura and the pleural space may be to permit the lungs to expand and deate easily within the chest. e pleural coverings allow the lungs to move with minimal friction and adjust their shape during changes in size. Because the space is under subatmospheric pressure with high compliance, the pleural space can also accommodate large volumes of liquid. ese collections, pleural eusions, are a common clinical issue. In this chapter, we will discuss what is known about normal movement of liquid and solutes into and out of the pleural space and how this balance is altered to allow excess liquid collection.
