How do exudative effusions develop in pleural effusions (fluid on the lungs)?

Updated: Dec 28, 2018
  • Author: Kamran Boka, MD, MS; Chief Editor: Guy W Soo Hoo, MD, MPH  more...
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Answer

Produced by a variety of inflammatory conditions (and often requiring a more extensive evaluation and treatment strategy than transudates), exudative effusions develop from inflammation of the pleura or from decreased lymphatic drainage at pleural edges. 

Mechanisms of exudative formation include pleural or parenchymal inflammation, impaired lymphatic drainage of the pleural space, transdiaphragmatic cephalad movement of inflammatory fluid from the peritoneal space, altered permeability of pleural membranes, and/or increased capillary wall permeability or vascular disruption. Pleural membranes are involved in the pathogenesis of the fluid formation. Of note, the permeability of pleural capillaries to proteins is increased in disease states with elevated protein content.


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