Respiratory and sleep medicine
Pleural effusion
Transudate or exudate by Light's criteria, the fluid tests that change management, pleural infection, malignant effusion options and the traps of heart failure on diuretics.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- A pleural effusion is fluid in the pleural space. Heart failure is the commonest cause overall; parapneumonic and malignant effusions are the commonest exudates.
- Bilateral effusions with a clear cause (heart failure, renal or liver failure) usually don't need a tap. Unilateral, febrile, or unexplained effusions do.
- Light's criteria separate exudate from transudate. They misclassify about a quarter of transudates on diuretics as exudates.
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Sources
- British Thoracic Society Guideline for pleural diseaseBritish Thoracic Society (Thorax), 2023
- British Thoracic Society clinical statement on pleural proceduresBritish Thoracic Society (Thorax), 2023
- ERS/ESTS statement on the management of pleural infection in adultsEuropean Respiratory Society and European Society of Thoracic Surgeons (European Respiratory Journal), 2023
- Therapeutic Guidelines: Antibiotic. Pleural infection (empyema)AU/NZTherapeutic Guidelines Limited (eTG complete), current eTG edition (version not verified)
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy