Pleural effusion, an abnormal accumulation of fluid in the pleural space, is a common and potentially serious condition in ICU settings. Studies indicate a prevalence of up to 60% among critically ill patients, with significant associations with mortality. It arises from diverse causes such as infection, malignancy, or systemic illnesses, often presenting with dyspnea, hypoxia, and reduced breath sounds. Management involves prompt identification, accurate diagnosis, and tailored interventions to mitigate adverse outcomes [1, 2] [Ref: Algorithm 86.1].