Question: For a patient with fluid building up in the lungs (recently having the same issue and having to have fluid drained via chest tube) due to a complication of CA, what is the best course of action? It wouldn't seem that a bronchodilator wouldn't be effective and since the fluid is of non-cardiogenic nature would nitro work?
You are correct. Fluid in the pleural space (between the chest wall and the lung but not actually in the lung itself) does not respond to bronchodilators, pre-load reduction with nitroglycerin, or really diuretics for that matter. The definitive therapy for malignant effusions (large amounts of pleural fluid related to underlying cancer) is removal via chest tube or chest needle drainage systems through a procedure called thoracentesis. Pre-hospital management of these patients is recognition, supplemental appropriate oxygen, and transport.