Problems outside the lung: Pneumothorax and pleural effusions

Abstract Pleural diseases, including pleural effusion and pneumothorax, are widely prevalent in critically ill patients and contribute significantly to the morbidity and mortality of patients admitted to ICUs. Management often includes thoracentesis or tube thoracostomy, and drained pleural fluid can be analyzed for further diagnostics and evaluation using Light’s criteria. Lung ultrasound to facilitate pleural drainage or tube thoracostomy may decrease the rate of procedure-related complications. Infected pleural collections, including parapneumonic effusion and empyema, have a high rate of treatment failure and are particularly challenging to manage, often requiring several bedside and/or surgical procedures. They are best managed by a multidisciplinary team of intensivists, pulmonologists, and thoracic surgeons.