{"id":5461,"date":"2025-05-26T15:02:55","date_gmt":"2025-05-26T12:02:55","guid":{"rendered":"https:\/\/neolife.innovatorspark.com\/valcea\/noutati\/revarsatul-pleural-unilateral-bilateral\/"},"modified":"2025-06-19T11:22:40","modified_gmt":"2025-06-19T08:22:40","slug":"revarsatul-pleural-unilateral-bilateral","status":"publish","type":"post","link":"https:\/\/neolife.innovatorspark.com\/valcea\/noutati\/revarsatul-pleural-unilateral-bilateral\/","title":{"rendered":"Rev\u0103rsatul pleural unilateral\/ bilateral"},"content":{"rendered":"<p>Acumulare de lichid \u00een spa\u021biul pleural<\/p>\n<h3>Simptomatologie<\/h3>\n<ul>\n<li>tuse seac\u0103, mai ales \u00een inspir<\/li>\n<li>durere toracic\u0103<\/li>\n<li>dispnee<\/li>\n<li>frisoane<\/li>\n<li>mialgii<\/li>\n<li>artralgii<\/li>\n<li>febr\u0103<\/li>\n<li>inapeten\u021b\u0103 \u0219i sc\u0103dere \u00een greutate<\/li>\n<\/ul>\n<h3>Diagnosticare<\/h3>\n<ul>\n<li>analize de s\u00e2nge \u2013 hemoleucogram\u0103, biochimie: uree seric\u0103, creatinin\u0103 seric\u0103, proteine serice, LDH, albumin\u0103 seric\u0103, TGO, TGP, bilirubin\u0103 direct\u0103, bilirubina total\u0103, gamaGT, coagulogram\u0103, sumar de urin\u0103 \u0219i proteine urinare<\/li>\n<li>examen sput\u0103 flor\u0103 banal\u0103, micologie \u0219i bK<\/li>\n<li><a href=\"\/radiologie-imagistica\/\">radiografie pulmonara<\/a> +\/- CT torace nativ \u0219i cu substan\u021b\u0103 de contrast<\/li>\n<li>toracocentez\u0103 evacuatorie \u0219i diagnostic\u0103 +\/- biopsie pleural\u0103 \/ toracoscopie exploratorie. \u00centotdeauna c\u00e2nd exist\u0103 rev\u0103rsate pleurale noi se practic\u0103 toracocentez\u0103.<\/li>\n<\/ul>\n<table>\n<tbody>\n<tr>\n<td width=\"251\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-5463\" src=\"https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-300x270.avif\" alt=\"\" width=\"300\" height=\"270\" srcset=\"https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-300x270.avif 300w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-467x420.avif 467w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-150x135.avif 150w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx.avif 630w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/td>\n<td width=\"214\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-5465\" src=\"https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-1-288x300.avif\" alt=\"\" width=\"288\" height=\"300\" srcset=\"https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-1-288x300.avif 288w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-1-403x420.avif 403w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-1-150x156.avif 150w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-1-300x313.avif 300w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-rx-1.avif 604w\" sizes=\"auto, (max-width: 288px) 100vw, 288px\" \/><\/td>\n<td width=\"254\"><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-medium wp-image-5464\" src=\"https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-eco-300x228.avif\" alt=\"\" width=\"300\" height=\"228\" srcset=\"https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-eco-300x228.avif 300w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-eco-552x420.avif 552w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-eco-80x60.avif 80w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-eco-150x114.avif 150w, https:\/\/neolife.innovatorspark.com\/valcea\/wp-content\/uploads\/sites\/9\/2025\/06\/revarsat-pleural-eco.avif 630w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/td>\n<\/tr>\n<tr>\n<td width=\"251\">\n<p style=\"text-align: center;\">Revarat pleural stang<\/p>\n<\/td>\n<td style=\"text-align: center;\" width=\"214\">Revarsat pleural drept inchistat<\/td>\n<td width=\"254\">\n<p style=\"text-align: center;\">Revarsat pleural identificat ecografic<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3>Tipuri de pleurezii:<\/h3>\n<table>\n<tbody>\n<tr>\n<td width=\"318\"><strong>TRANSUDAT<\/strong><strong>Proteine LP&lt;3g\/dL. Proteine din LP\/proteina din s\u00e2nge&lt;0.5. LDH din LP\/LDH din s\u00e2nge&lt;0.6<\/strong><\/td>\n<td width=\"312\"><strong>EXUDAT<\/strong><strong>Proteina LP&gt;3g\/dL. Proteine din LP\/proteina din s\u00e2nge&gt;0.5. LDH din LP\/LDH din s\u00e2nge&gt;0.6<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"318\">Insuficien\u021b\u0103 cardiac\u0103 congestiv\u0103<\/td>\n<td width=\"312\">Cauze infec\u021bioase \u2013 bacteriene, virale, fungice, parazitare, micobacterii<\/td>\n<\/tr>\n<tr>\n<td width=\"318\">Ciroz\u0103 hepatic\u0103<\/td>\n<td width=\"312\">Cauze neoplazice \u2013 <strong>primare<\/strong>: cancer pulmonar, mezoteliom, <strong>secundare:<\/strong> limfom, cancer s\u00e2n, ovarian, prostat\u0103, rinichi, pancreas, stomac<\/td>\n<\/tr>\n<tr>\n<td width=\"318\">Sindrom nefrotic<\/td>\n<td width=\"312\">Trombembolism pulmonar<\/td>\n<\/tr>\n<tr>\n<td width=\"318\">Hipoalbuminemie<\/td>\n<td width=\"312\">Cauze gastrointestinale: perfora\u021bie de esofag, hernie diafragmatic\u0103, pancreatite acute\/cronice, abces subfrenic, abces hepatic<\/td>\n<\/tr>\n<tr>\n<td width=\"318\">Dializ\u0103 peritoneal\u0103<\/td>\n<td width=\"312\">Boli reumatologice (colagenoze): poliartrit\u0103 reumatoid\u0103, lupus eritematos sistemic, sindrom Sjogren, grnulomatoz\u0103 Wegener<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" width=\"630\">Toxicitate medicamentoas\u0103. Sindromul unghiilor galbene.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>\u00cen func\u021bie de <strong>etiologia rev\u0103rsatului pleural, clinic\u0103, stare biologic\u0103, analiza lichidului pleural<\/strong> se pot administra simptomatice, medica\u021bie antibiotic\u0103, medica\u021bie antituberculoas\u0103, medica\u021bie anticoagulant\u0103 sau medica\u021bie \u00een vederea reechilibr\u0103rii bolii de baz\u0103.<\/p>\n<p><strong>\u00a0<\/strong><strong style=\"color: initial;\">BIBLIOGRAFIE<\/strong><\/p>\n<ol>\n<li>Celli BR, Fabbri LM, Aaron SD, Agusti A, Brook R, Criner GJ, Franssen FME, Humbert M, Hurst JR, O&#8217;Donnell D, Pantoni L, Papi A, Rodriguez-Roisin R, Sethi S, Torres A, Vogelmeier CF, Wedzicha JA. An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal. Am J Respir Crit Care Med. 2021 Dec 1;204(11):1251-1258.<\/li>\n<li>Celli BR, Fabbri LM, Aaron SD, Agusti A, Brook R, Criner GJ, Franssen FME, Humbert M, Hurst JR, O&#8217;Donnell D, Pantoni L, Papi A, Rodriguez-Roisin R, Sethi S, Torres A, Vogelmeier CF, Wedzicha JA. An Updated Definition and Severity Classification of Chronic Obstructive Pulmonary Disease Exacerbations: The Rome Proposal. Am J Respir Crit Care Med. 2021 Dec 1;204(11):1251-1258.<\/li>\n<li>Dubin S, Patak P, Jung D. Update on Asthma Management Guidelines. Mo Med. 2024 Sep-Oct;121(5):364-367.<\/li>\n<li>Reddel HK, FitzGerald JM, Bateman ED, Bacharier LB, Becker A, Brusselle G, Buhl R, Cruz AA, Fleming L, Inoue H, Ko FW, Krishnan JA, Levy ML, Lin J, Pedersen SE, Sheikh A, Yorgancioglu A, Boulet LP. GINA 2019: a fundamental change in asthma management: Treatment of asthma with short-acting bronchodilators alone is no longer recommended for adults and adolescents. Eur Respir J. 2019 Jun 27;53(6):1901046.<\/li>\n<li>Pasteur MC, Bilton D, Hill AT; British Thoracic Society Bronchiectasis non-CF Guideline Group. British Thoracic Society guideline for non-CF bronchiectasis. Thorax. 2010 Jul;65 Suppl 1:i1-58.<\/li>\n<li>De Soyza A, Brown JS, Loebinger MR; Bronchiectasis Research &amp; Academic Network. Research priorities in bronchiectasis. Thorax. 2013 Jul;68(7):695-6.<\/li>\n<li>Tsang KW, Chan K, Ho P, Zheng L, Ooi GC, Ho JC, Lam W. Sputum elastase in steady-state bronchiectasis. Chest. 2000 Feb;117(2):420-6.<\/li>\n<li>Mandal P, Morice AH, Chalmers JD, Hill AT. Symptoms of airway reflux predict exacerbations and quality of life in bronchiectasis. Respir Med. 2013 Jul;107(7):1008-13.<\/li>\n<li>Grief SN, Loza JK. Guidelines for the Evaluation and Treatment of Pneumonia. Prim Care. 2018 Sep;45(3):485-503.<\/li>\n<li>Kaysin A, Viera AJ. Community-Acquired Pneumonia in Adults: Diagnosis and Management. Am Fam Physician. 2016 Nov 1;94(9):698-706. Erratum in: Am Fam Physician. 2017 Apr 1;95(7):414.<\/li>\n<li>Casey C, Fullerton MJ, Somerville N. Common Questions About Pneumonia in Nursing Home Residents. Am Fam Physician. 2015 Oct 1;92(7):612-20.<\/li>\n<li>Ebell MH. Predicting pneumonia in adults with respiratory illness. Am Fam Physician. 2007 Aug 15;76(4):560-2.<\/li>\n<li>Korownyk C, Allan GM. Evidence-based approach to abscess management. Can Fam Physician. 2007 Oct;53(10):1680-4.<\/li>\n<li>Stewart MP, Laing MR, Krukowski ZH. Treatment of acute abscesses by incision, curettage and primary suture without antibiotics: a controlled clinical trial. Br J Surg. 1985 Jan;72(1):66-7.<\/li>\n<li>Yu H. Management of pleural effusion, empyema, and lung abscess. Semin Intervent Radiol. 2011 Mar;28(1):75-86.<\/li>\n<li>Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med. 1972 Oct;77(4):507-13.<\/li>\n<li>Schiza S, Siafakas NM. Clinical presentation and management of empyema, lung abscess and pleural effusion. Curr Opin Pulm Med. 2006 May;12(3):205-11.<\/li>\n<li>Ministerul S\u0103n\u0103t\u0103\u021bii, Institutul de Pneumoftiziologie Marius Nasta, Ghid Metodologic de implementare a programului na\u021bional de prevenire, supraveghere \u0219i control al tuberculozei \u0219i altor micobacterioze, Bucure\u0219ti, 2022.<\/li>\n<li>Sub redac\u021bia Cristian Oancea, Ovidiu Fira \u2013 Ml\u0103dinescu, Voicu Tudorache, Tratat de Pneumologie pentru medicii reziden\u021bi, Timi\u0219oara, editura Victor Babe\u0219, 2021.<\/li>\n<li>Sub redac\u021bia Miron Alexandru Bogdan, Pneumologie, Bucure\u0219ti, editura universitar\u0103 Carol Davila, 2008.<\/li>\n<li>Reprezent\u0103ri grafice preluate de pe Radiopaedia.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Acumulare de lichid \u00een spa\u021biul pleural Simptomatologie tuse seac\u0103, mai ales \u00een inspir durere toracic\u0103 dispnee frisoane mialgii artralgii febr\u0103 inapeten\u021b\u0103 \u0219i sc\u0103dere \u00een greutate Diagnosticare analize de s\u00e2nge \u2013 hemoleucogram\u0103, biochimie: uree seric\u0103, creatinin\u0103 seric\u0103, proteine serice, LDH, albumin\u0103 seric\u0103, TGO, TGP, bilirubin\u0103 direct\u0103, bilirubina total\u0103, gamaGT, coagulogram\u0103, sumar de urin\u0103 \u0219i proteine urinare [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":5462,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[29],"tags":[],"class_list":["post-5461","post","type-post","status-publish","format-standard","has-post-thumbnail","category-articole"],"acf":[],"_links":{"self":[{"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/posts\/5461","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/comments?post=5461"}],"version-history":[{"count":3,"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/posts\/5461\/revisions"}],"predecessor-version":[{"id":5816,"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/posts\/5461\/revisions\/5816"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/media\/5462"}],"wp:attachment":[{"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/media?parent=5461"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/categories?post=5461"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/neolife.innovatorspark.com\/valcea\/wp-json\/wp\/v2\/tags?post=5461"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}