Pleural Effusion

Also See Ascites Fluid Analysis
Decubitus Films
(-) Moves (+) Moves
(+) Fluid
Thoracentesis
  Transudate Exudate
  Hydrostatic Pressure - CHF = ProBNP
Oncotic Pressure = Cirrhosis, Nephrotic syndrome
- Infection, Inflammation, Malignancy
- Lights Criteria:
 - Pleural fluid protein/Serum ratio > 0.5
 - Pleural fluid LDH/Serum ration > 0.6
 - Pleural fluid LDH > 2/3 of normal serum LDH
Protein < 3.0 > 3.0 > 4.0 TB
7.0 - 8.0 Waldenstroms Macroglobulinemia
Multiple Myeloma
LDH < 200 > 200 PJP (pneumonia)
> 1000 Empyema
Rheumatic Pleurisy
Pleural Paragonimiasis
Cholesterol   > 250
TGL    
Glucose - Normal < 60 30 - 50 Infection
Malignancy
< 30 Empyema
Rheumatic effusion
pH 7.40 - 7.55 7.30 - 7.45
< 7.30 Empyema (Acid Production)
Pleuritis
Tumor
Pleural fibrosis
Malignancy
Rheumatic pleurisy
TB Pleurisy
Amylase   Acute Pancreatitis
Chronic pancreatic pleural effusion
Esophageal rupture
Malignancy
Adenosine deaminase   - Tuberculosis Pleurisy
ProBNP  
Tumor Markers   CEA, CA-125, CA 15-3, CA 19-9