ICU Chest Films > Fluid in the Chest > Pleural Effusions

Pleural Effusions

Pleural effusions are accumulations of fluid within the pleural space. These fluids include blood, chyme, pus, transudates or exudates. In the ICU patient, pleural effusions are extremely common. In patients on medical services the most common cause is congestive heart failure, while up to two-thirds of patitient will develop pleural effusions following upper abdominal surgery. Patients undergoing thoracotomy or median sternotomy will also usually develop pleural effusions. Other causes of fluid accumulation in the intrapleural space include pulmonary embolism, neoplastic disease, subphrenic inflammatory processes (e.g. pancreatitis), pneumonia, trauma, and ascites.

This patient has large bilateral effusions; notice the density gradient in each lung field.