How is pleural effusion diagnosed? What are the potential complications?

Complications mainly include lower respiratory tract infection, spontaneous pneumothorax, and respiratory failure.

1.1 Imaging examination diagnosis

Imaging examination has a high diagnostic value. Through chest CT, chest ultrasound and other examinations, it can observe whether there is fluid accumulation in the pleural cavity. Imaging examination can also observe the pleural lesions and causes.

1.2 Diagnosis by puncture aspiration examination

Through pleural puncture aspiration examination, the glucose, PH value, bilirubin, pathogens, etc. in the pleural fluid can be analyzed, which has a greater diagnostic value for pleural effusion.

1.3 Diagnosis based on symptoms

Patients with pleural effusion will have obvious chest pain, especially when inhaling, the symptoms will be aggravated. Based on this symptom, pleural effusion can be simply diagnosed.

2.1 Lower respiratory tract infection

Patients with pleural effusion and pleurisy are prone to lower respiratory tract infection due to old age, weak body, malnutrition, decreased immune function, narrow airway, and secretion retention. Patients often transition from a stable period to a worsened period due to this. It is worth noting that elderly patients with infections often do not have fever and the total number of white blood cells is not high. Cough, increased shortness of breath, increased sputum volume, and purulent sputum are the earliest and most important signs of lower respiratory tract infection.

2.2 Spontaneous pneumothorax

It is mostly caused by rupture of pulmonary bullae. There may be intense coughing or exertion as predisposing factors, or there may be no predisposing factors. The typical manifestations are chest pain and sudden dyspnea, and percussion of the affected area shows hyperresonance. Elderly patients often do not have chest pain and only manifest as progressive worsening of dyspnea. X-ray examination can show pneumothorax. Due to the poor basic lung function of elderly patients, even if the lung compression is not much, the condition can be severe, and timely rescue is necessary.

2.3 Respiratory failure

Severe elderly patients with emphysema are prone to respiratory muscle fatigue due to increased respiratory work, low diaphragm, increased radius of curvature, and malnutrition. Respiratory failure is often induced by factors such as lower respiratory tract infection, concomitant other diseases, surgery, and fatigue on this basis. Improper use of oxygen therapy, sedatives, antitussives, and other iatrogenic factors may also lead to respiratory failure.