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Acute management at exudative pleurisy

Pleurisy exudative is observed at tuberculosis, pneumonia, rheumatism, an injury of a breast, a lung tumor.
Symptoms. The beginning can be acute (a fever, temperature increase, cough, pain at breath) or gradual. Quickly enough an asthma arises and progresses. The patient prefers to lie on a sick side. The smoothness of intercostal spaces and lag in the act of breath of the sick party attract attention. Perkutorno decides obtusion (dullness) of a sound on the upper bound in the area of Damuazo (at left-side localization disappearance of semi-lunar space of Traube is observed). Voice trembling on the sick party is not defined; breath in this zone is not carried out or is sharply weakened, over an exudate zone — bronchial. Heart is displaced in the healthy party, tones are muffled. By the ABP it is lowered, collapse cases meet. Purulent pleurisy (a serious general condition, high fever, oznoba, an asthma) differs in the expressed weight of a current.
Diagnosis. The exudate in a pleura can be connected not only with inflammatory process, but also with heart failure, a disease of kidneys, tumors (hemorrhagic character of exudate), pancreatitis, portal hypertensia.
Complications: acute cardiovascular insufficiency, respiratory insufficiency; the empyema of a pleura can be complicated by a tension pneumothorax or piopnevmogoraksy.
Acute management. Oxygen — 4 — 6 l/min. At an asthma more than 40 in a minute and an unstable hemodynamics — the emergency puncture of a pleural cavity and slow removal of liquid.
Hospitalization: in the block of an intensive care of profile department.

 
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