![]() ![]() An initial gram stain should be performed looking for any bacterial microorganisms. MicrobiologyĪ sample of pleural fluid should be sent to microbiology to analyse for an infection. LDH is useful as part of Lights criteria to help further differentiate between transudates and exudates. The pH of normal pleural fluid is alkalotic (pH 7.60) due to the high bicarbonate content. pHĪ sample of pleural fluid should be run through a blood gas machine to determine the pH. The reason for these tests is discussed in detail below. Other investigations are guided by the suspected cause (e.g. The basic set of investigations that should be conducted on pleural fluid include pH, gram stain, microscopy, culture, and sensitivity (MC&S), protein count, lactate dehydrogenase (LDH), and cytology. Several investigations can be requested on pleural fluid to determine the cause of the pleural effusion. systemic lupus erythematosus, rheumatoid arthritis) Parapneumonic effusion (secondary to pneumonia).Exudates are commonly due to infection or malignancy. It develops due to a variety of inflammatory conditions that affect vessel permeability and/or lymphatic drainage. Meigs' syndrome (Ascites and pleural effusion in association with a benign ovarian tumour).Īn exudate is a fluid with a high protein and cellular content.It occurs due to alteration in hydrostatic and oncotic pressures leading to the fluid being ‘squeezed’ into the pleural space (ultrafiltration). TransudateĪ transudate is a fluid with minimal protein or cellular content. hydrothorax) the causes can be broadly divided into transudates and exudates. When referring to a simple pleural effusion (i.e. haemothorax) usually have a clear cause (e.g. Specific causes of pleural effusion (e.g. The causes of a pleural effusion can be broadly divided into transudates and exudates. ![]()
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