Pleural space

The transcellular fluid includes the viscous components of the peritoneum, pleural space, and pericardium, as well as the cerebrospinal fluid, joint space fluid, and the gastrointestinal (GI) digestive juices. Although the transcellular fluid normally accounts for about 1% of TBW, this amount can increase significantly during various illnesses favoring fluid collection in one of these spaces (e.g., pleural effusions or ascites in the peritoneum). The accumulation of fluid in the transcellular space is often referred to as third spacing. To review the calculations of the body fluid compartments in a representative patient, see Patient Encounter 1. 

Thoracentesis Removal of fluid present in the pleural space a common procedure to determine the cause of fluid accumulation. 

Transpulmonary pressure (Plp) is the pressure difference between the inside and outside of the lungs. In other words, it is the pressure difference between the alveoli and the pleural space ... 

The entry of air into the pleural cavity is referred to as a pneumothorax. This may occur spontaneously when a "leak" develops on the surface of the lung, allowing air to escape from the airways into pleural space. It may also result from a physical trauma that causes penetration of the chest wall so that air enters pleural space from the atmosphere. In either case, the pleural cavity is no longer a closed space and the pressure within it equilibrates with the atmospheric pressure (0 cmH20). As a result, the transpulmonary pressure is also equal to 0 cmH20 and the lung collapses. 

Recently, the toxicological responses of CNTs in the intra-abdominal cavity have attraded significant attention. Studies have been carried out mainly in vivo, and only three in vitro models have been tested. The significance of these studies is unknown, however, since no evidence indicating that CNTs can reach the pleural space is currently available. 

Other routes - Concentrations of 0.25% have been used as irrigating solutions in abscess cavities, pleural space, peritoneal and ventricular cavities. 

Candidemia and other Candida infections For the treatment of candidemia and the following Candida infections intra-abdominal abscesses, peritonitis, and pleural space infections. 

Pneumonitis. Inflammation of the lungs. Pneumothrax. An accumulation of air or gas in the pleural space, which may occur spontaneously or as a result of trauma or a... 

Crack, the heat stable form of cocaine, when smoked and followed by deep inhalation plus a Valsalva maneuver to increase uptake, and cough triggered by the sniffed substance can cause pulmonary barotrauma. The increased intra-alveolar pressure can cause alveolar rupture, with consequent air dissection through the peribronchial connective tissue in the mediastinum, pleural space, pericardium, peritoneum, or subcutaneous soft tissues. 

Pleural effusion Cells (fluid) can ooze or weep from the lung tissue into the space between the lungs and the chest cavity (pleural space) causing a pleural effusion. The effusion fluid may be clear or bloody. Pleural effusions may be an early sign of asbestos exposure or mesothelioma and should be evaluated. 

Several antineoplastic agents have been introduced into the pleural space to achieve pleurodesis, but the largest reported experience is with bleomycin. Intrapleural bleomycin has an efficacy similar to that of tetracycline and doxycycline (16). About 45% of a dose of bleomycin is... 

The chnical differentiation of chylothorax from leakage of parenteral nutrition fluid into the pleural space can be difficult. However, in one case the diagnosis of leakage of parenteral nutrition fluid was made by additional tests of electrolytes, showing very high concentrations of potassium (11.3 mmol/1) and glucose (128 mmol/1), mhng out chylothorax (13). 

The aim of pleurodesis is to produce fusion between the visceral and parietal pleural surfaces and so prevent the accumulation of air or fluid in the pleural space. In a chemical pleurodesis, this fusion is generally achieved by the instillation of agents that induce an inflammatory response on the pleural surfaces. These agents can be introduced into the pleural space through a chest tube at the bedside or during thoracoscopy/thoracotomy. 

Talc can be insufflated into the pleural space in a powder form, usually at thoracoscopy or thoracotomy (talc poud-rage), or can be mixed with normal saline and instilled through a standard chest tube as talc slurry. 

Transcellular fluid Fluid in the gastrointestinal (GI) tract, cerebrospinal space, aqueous humor, pleural space, synovial space, and the peritoneal space ° Plasma fluid... 

Heart failure causes Kerley s B lines (edema of interlobular septa), which appear as thin, horizontal reticular fines in the costophrenic angles. At higher pressures, alveolar edema and pleural effusions appear in the pleural space or as blunting of the costophrenic angles. Pericardial effusions also may appear as a large heart, but because it usually occurs rapidly, there is no evidence of pulmonary venous congestion. 

Mechanical restriction caused by chest bellows malfunction may result from chest wall or skeletal deformity, loss of neuromuscular function, fibrosis of the pleural space, and abdominal overdistension causing upward displacement of the diaphragm, as well as decreased diaphragm movement. The most common pulmonary function pattern seen in these patients is a decrease in TLC and VC with only a slight decrease in RV. The RV is maintained in these diseases because lung compliance remains normal. The Dlco is normal or only minimally reduced, and the Dlco a (corrected for alveolar volume) is normal. The RV/TLC ratio is often increased in patients with restrictive chest bellows disease. Patients with neuromuscular disease also have reduced respiratory muscle function with a reduction in their MIP. 

Bartlett JG. Anaerobic bacterial infections of the lung and pleural space. Clin Infect Dis 1993 16(suppl 4) S248-255. 

Pneumothorax Perforation of the pleura or lung during insertion, which results in air collection in the pleural space... 

Oonakahara K., Matsuyama W., Higashimoto I., et al.. (2004) Stromal-derived factor-lalpha/CXCL12-CXCR 4 axis is involved in the dissemination of NSCLC cells into pleural space. Am J Respir Cell Mol Biol., 3b0, 671-7. 

Compliance is defined as the change in volume produced by a unit change in lung elastic recoil pressure and is the most commonly measured index of the elastic properties of the lung. Elastic recoil pressure is the difference between the pressure in the alveolus and the pressure in the pleural space (intrapleural pressure). 

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