ABSTRACT
Pleural effusions can occur as complications of many different diseases (pulmonary or extrapulmonary) and almost always constitute a matter of concern for the physician (1). Concern primarily derives from what pleural effusions represent (infection, malignancy, embolism, hemothorax, or other) as well as from the difficulties of their diagnostic approach and rarely from the physiological consequences of fluid collection on lung mechanics and gas exchange. Patients in the intensive care unit (ICU) are rarely admitted for primary pleural disease causing respiratory insufficiency (hemothorax, hydropneumothorax, massive effusions) (2). However, in the medical ICU setting, pleural effusions are common but frequently benign and, when analyzed, only occasionally require or alter treatment, but this may be not the case in the surgical or trauma ICU (2). Furthermore, pleural effusions in the ICU frequently go unrecognized on supine radiographs (especially if small to moderate and bilateral) and occasionally when remain undiagnosed may add to morbidity and mortality.
