دورية أكاديمية

The laboratory investigation of pleural fluids: An update based on the available evidence

التفاصيل البيبلوغرافية
العنوان: The laboratory investigation of pleural fluids: An update based on the available evidence
المؤلفون: Arrigo, Claudia, Aloisio, Elena, Rovegno, Leila, Dolci, Alberto, Panteghini, Mauro
المصدر: Annals of Clinical Biochemistry: International Journal of Laboratory Medicine ; volume 60, issue 4, page 228-235 ; ISSN 0004-5632 1758-1001
بيانات النشر: SAGE Publications
سنة النشر: 2023
مصطلحات موضوعية: Clinical Biochemistry, General Medicine
الوصف: Selecting appropriate laboratory tests based on available evidence is central to improve clinical effectiveness and impacting on patient outcome. Although long studied, there is no mutual agreement upon pleural fluid (PF) management in the laboratory context. Given the experienced confusion about the real contribution of laboratory investigations to guide clinical interpretation, in this update, we tried to identify useful tests for the PF analysis, aiming to unravel critical points and to define a common line in requesting modalities and practical management. We performed a careful literature review and a deepened study on available guidelines to finalize an evidence-based test selection, intended for clinicians’ use to streamline PF management. The following tests depicted the basic PF profile routinely needed: (1) abbreviated Light’s criteria (PF/serum total protein ratio and PF/serum lactate dehydrogenase ratio) and (2) cell count with differential analysis of haematological cells. This profile fulfils the primary goal to determine the PF nature and discriminate between exudative and transudative effusions. In specific circumstances, clinicians may consider additional tests as follows: the albumin serum to PF gradient, which reduces exudate misclassification rate by Light’s criteria in patients with cardiac failure assuming diuretics; PF triglycerides, in differentiating chylothorax from pseudochylothorax; PF glucose, for identification of parapneumonic effusions and other causes of effusion, such as rheumatoid arthritis and malignancy; PF pH, in suspected infectious pleuritis and to give indications for pleural drainage; and PF adenosine deaminase, for a rapid detection of tuberculous effusion.
نوع الوثيقة: article in journal/newspaper
اللغة: English
DOI: 10.1177/00045632231157547
الإتاحة: https://doi.org/10.1177/00045632231157547Test
حقوق: http://journals.sagepub.com/page/policies/text-and-data-mining-licenseTest
رقم الانضمام: edsbas.637D825C
قاعدة البيانات: BASE