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An accurate diagnosis of the cause of the effusion, transudate versus exudate, relies on a comparison of the chemistries in the pleural fluid to those in the blood, using Light's criteria. According to Light's criteria (Light, et al. 1972), a pleural effusion is likely exudative if at least one of the following exists: [31]
On the surface of this solution, 1 drop of the effusion fluid is carefully layered. If the drop disappears and the solution remains clear, the Rivalta's test is defined as negative. If the drop retains its shape, stays attached to the surface or slowly floats down to the bottom of the tube (drop- or jelly-fish-like), the Rivalta's test is ...
Transudate is extravascular fluid with low protein content and a low specific gravity (< 1.012). It has low nucleated cell counts (less than 500 to 1000 per microliter) and the primary cell types are mononuclear cells: macrophages, lymphocytes and mesothelial cells. For instance, an ultrafiltrate of blood plasma is transudate.
(See below for difference between transudate and exudate) Malignant (or cancerous) pleural effusion is effusion where cancer cells are present. [11] It is usually classified as exudate. Types of exudates: serous, serosanguineous, sanguineous, hemorrhaging and purulent drainage. Serous: Clear straw colored liquid that drains from the wound.
Transudate: Exudate: Main causes ↑ hydrostatic pressure, ↓ colloid osmotic pressure: Inflammation-Increased vascular permeability: Appearance: Clear [1] Cloudy [1] Specific gravity < 1.012 > 1.020 Protein content < 2.5 g/dL > 2.9 g/dL [2] fluid protein/ serum protein < 0.5 > 0.5 [3] SAAG = Serum [albumin] - Effusion [albumin] > 1.2 g/dL < 1 ...
Chemistry studies may be performed including pH, pleural fluid:serum protein ratio, LDH ratio, specific gravity, cholesterol level, and bilirubin level. These studies may help clarify the etiology of a pleural effusion (exudative vs transudative).
The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate. [2] The formula is as follows: SAAG = (serum albumin) − (albumin level of ascitic fluid). Ideally, the two values should be measured at the same time.
It is one of the various kinds of pleural effusion. There are three stages: exudative, when there is an increase in pleural fluid with or without the presence of pus; fibrinopurulent, when fibrous septa form localized pus pockets; and the final organizing stage, when there is scarring of the pleura membranes with possible inability of the lung ...
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