Mechanism and causes of a pleural effusion

• Altered permeability of membranes: inflammatory process, neoplasm
• Reduction in intravascular oncotic pressure: hypoalbuminemia, cirrhosis
• Increased capillary hydrostatic pressure: CHF
• Inability of lung to expand: atelectasis, mesothelioma
• Decreased lymphatic drainage: thoracic duct obstruction
• Increased fluid in peritoneal cavity: migration of fluid across diaphragm via lymphatics
• Iatrogenic: central line misplacement

What is Atelectasis?

Atelectasis is the lack of gas exchange within alveoli. It is commonly seen after surgery in smokers and therefore physicians routinely order a chest xray to look for signs of alveolar damage or fluid causing consolidation. Cough, chest pain, tachycardia, tachypnea and fever are common symptoms. A procedure to remove mucus plugs known as bronchoscopy is done along with deep breathing, coughing and incentive spirometry. Sometimes, antibiotics are given to prevent infection.

Most Common Questions about Hypersensitivity Pneumonitis

Occupational Lung Disease:
Hypersensitivity Pneumonitis

What is COPD?

COPD

Hypercapnia Strategy To Improve Lung Function

Permissive hypercapnia helps in developing a protective lung ventilatory strategy. Hypercapnic acidosis has shown to be lifesaving in cases of ALI and systemic organ injury. However, more studies need to be done to determine how it affects cases of sepsis and it’s advantage when low tidal volume ventilation for adults with ARDS is considered as a treatment option.

Reference:

Bench-to-bedside review: Permissive hypercapnia, Donall O' Croinin, Martina Ni Chonghaile, Brendan Higgins, and John G Laffey Crit Care.

Antioxidants to reduce oxidative stress in COPD

 

Thiol antioxidants and mucolytic agents, such as glutathione, N-acetyl-L-cysteine, N-acystelyn, erdosteine, fudosteine and carbocysteine; Nrf2 activators; and dietary polyphenols (curcumin, resveratrol, and green tea catechins/quercetin) have been reported to reduce the number of free radicals and oxidants as well as cause the inhibition of inflammatory responses in cases of COPD exacerbation.

Reference:

Published in final edited form as: Ther Adv Respir Dis. 2008 December; 2(6): 351–374. doi:
Manuscript: | Abstract | Full Text |

Vaccine for COPD?

A new oral immunotherapy (HI-164OV) using Haemophilus influenzae, has led to the formation of a new vaccine for patients with severe COPD.

Reference:

M. K. Tandon, M. Phillips, G. Waterer, M. Dunkley, P. Comans, R. Clancy. Oral Immunotherapy with inactivated NTHi reduces severity of acute exacerbations in severe COPD. Chest