Pleural effusion (fluid around the lungs)

Easily explained !

Short and simple

The most common causes of pleural effusion

  • Cancer
  • Heart failure
  • Pneumonia

Symptoms of pleural effusion

  • Shortness of breath
  • Chest pain
  • Coughing

Synonyms for pleural effusion

  • Pleural fluid
  • Water on the lungs
  • Fluid around the lungs

How to treat pleural effusion

  • One-time drainage (thoracentesis)
  • Pleurodesis (talc/mepakrin)
  • Indwelling pleural catheter

Pleura (pleural sac)

The pleura is a thin membrane in the chest made up of two membranes, which are also called layers. The inner layer surrounds the lung and is called visceral pleura. The outer layer lines the inside of the chest wall and is called parietal pleura. Between these two layers is the pleural cavity. The pleural cavity contains a few millimetres of fluid, allowing the two layers to slide together when you breathe. Much like two sheets of glass with a film of liquid between them.

Illustration of the lung with pleura (pleural sac) including parietal pleura and visceral pleura.

What is pleural effusion?

Pleural effusion means that the pleura (pleural sac), which we have described above, fills up with more fluid than normal. In a healthy person, there are a few millilitres of fluid in the pleural cavity to allow the two pleura sheets to move painlessly.

In a person suffering from pleural effusion, the fluid in the pleura surrounding the lungs fills up. When the fluid reaches a certain extent, it affects breathing, as the lung can no longer fully expand due to the fluid.

Why does pleural effusion occur?

There are various diseases that can cause pleural effusion. In a long list of diseases, the most common cause of pleural effusion is cancer (malignant tumour). Heart failure or pneumonia can also cause pleural effusion.

Lung cancer followed by breast cancer are the most common causes of a malignant (arising from a malignant tumour) pleural effusion.

Illustration of the lung with pleural effusion.

Before I got PleurX, I was drained of fluid 1-2 times/week and had 5 miles to the hospital. Since I received my PleurX a month ago, I have not had to go to the hospital. It’s so important to be able to take advantage of the time at home and avoid hospitalisation. When I come to the hospital I am reminded that I am sick, but when I can be at home I don’t feel sick.

– Lotta from Kalmar / pleural effusion (cancer) –

How to treat pleural effusion?

There are various treatment options to treat recurrent pleural effusion:

Pleural drainage (thoracentesis)

During a pleural drainage, the excess fluid is withdrawn with a syringe through a cannula. This procedure is often performed in an outpatient setting. When the fluid builds up again, you have to go back to the hospital to have a new pleural tap.


Depending on the underlying disease and the nature of the fluid, recurrent fluid can be treated with a chemical pleurodesis. An agent, usually talc or mepakrin, is injected into the pleural cavity to cause inflammation. If the treatment is successful, the pleura layers stick together and the fluid stops filling the pleural cavity. This is called a pleurodesis.

Pleurodesis treatment requires up to a week’s stay in hospital.

Indwelling catheter

At ewimed, we recommend immediate implantation of an indwelling pleural catheter in case of recurrent pleural effusion. Getting the catheter early increases the chance of spontaneous pleurodesis.

An indwelling catheter has a great advantage for the patient. You don’t have to go to the hospital repeatedly for the doctor to perform a thoracentesis. It is also possible to get spontaneous pleurodesis by draining fluids regularly. Spontaneous pleurodesis means that the fluid stops building up.

The patient thus has more time at his or her disposal, as the fluid can be drained at home without the need for a doctor to be present. This increases the patient’s mobility and quality of life.

Other benefits of an indwelling catheter include fewer hospital stays, low risk of infection and complications.

More information about the catheter

Brief overview of the benefits of our indwelling catheters

  • enables independent, fast and patient-safe drainage at home.
  • no further hospitalisation due to the fluid
  • simple and easy to use
  • no repeated, painful thoracentesis
  • a single minimally invasive procedure to implant the catheter
  • highest patient safety thanks to the unique connection to the drainage set
  • increased mobility and independence for you as a patient
  • reduced risk of infection
  • high level of spontaneous pleurodesis of pleural effusion without further intervention

Important information

The European and American medical organisations in thoracic surgery and pulmonary medicine also recommend implanting an indwelling pleural catheter in case of recurrent fluid since 2018. The reason is that it provides effective symptom relief and reduced hospital stays with good chances of a pleurodesis. (Sources: Europa USA)

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