This week, we speak to Dr. Laura Gleeson again—this time about pleural effusions. Our conversation covers all the pleural effusion basics, plus the nuances of radiology, when to insert a chest drain, and how to monitor it once it’s in place.

Chapters:

01:05 – Rapid fire round

04:23 – Pleural effusion intro

05:30 – Symptoms at presentation with pleural effusion

06:40 – Interpreting a white-out on CXR

07:20 – When to do further radiology/imaging

08:35 – CT pre or post chest drain insertion?

10:25 – Light’s criteria – can it always be trusted?

12:00 – What tests to send on your pleural fluid sample

14:15 – Chest drain indications

16:35 – Monitoring your chest drain

21:00 – Flushing the chest drain

22:20 – How much fluid to drain

25:00 – Removing the chest drain

27:10 – Empyema management

30:10 – Fibrinolysis

31:55 – Following up your pleural patients

34:10 – Take-home points

Show notes & resources:

Light’s criteria – MDCalc calculator | CHEST Clinics article

MIST trials – MIST2 – NEJM | MIST3 – ATS Journals