CHEST 2023 On Demand Pass-Management of Nonmalignant Pleural Effusion

Video Transcription

Video Summary

In this video, the speaker covers the management of non-malignant pleural effusion, focusing on chylothorax and empyema. They discuss the anatomy of the thoracic duct and the challenges in managing chylothorax. Diagnosis is confirmed through fluid analysis and triglyceride levels. The management approach depends on the etiology, and a multidisciplinary approach involving different specialties is emphasized. Dietary modification, pharmacological therapy, and interventions like ligation, embolization, or pleurodisis can be used. Ongoing research is being conducted to establish guidelines for managing chylothorax. For empyema, a stepwise approach is recommended, starting with a chest tube and antibiotics. If flushing is insufficient, tPA-DNA therapy can be considered, but surgery may be necessary if it fails. Timely decision-making and involving a multidisciplinary team are crucial. For hepatic hydrothorax, limited data is available, and patient-specific factors should be considered. Medical management, TIPS, and repeat thoracentesis are discussed. The management of hemothorax involves chest tubes and surgery, with complete drainage and pulmonary expansion as goals. Imaging, such as chest CT scans, is recommended for evaluating retained hemothorax. Surgical outcomes are generally positive, with lower reintervention rates compared to chest tubes. The need for individualized management based on patient and condition is emphasized throughout.

Meta Tag

Category Disorders of the Pleura

Session ID 1005

Speaker Abhinav Agrawal

Speaker Udit Chaddha

Speaker Erin Gillaspie

Speaker Samira Shojaee

Track Disorders of the Pleura

Track Procedures

Keywords

chylothorax

empyema

multidisciplinary approach

fluid analysis

triglyceride levels

pleurodesis

surgery for empyema

hepatic hydrothorax

chest tubes

individualized management