The distinction between transudates and exudates |
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Authors: | Email author" target="_blank">Ugur?GonlugurEmail author Tanseli?Efeoglu?Gonlugur |
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Institution: | (1) Department of Chest Diseases, Cumhuriyet University Medical School, 58140 Sivas, Turkey;(2) Department of Chest Diseases, Sivas State Hospital, Sivas, Turkey |
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Abstract: | Summary The first step in the diagnosis of pleural effusions is the distinction between exudates and transudates. The aim of this
study was to evaluate the usefulness of various parameters for the differentiation of pleural exudates and transudates. We
recorded clinical characteristics, final diagnoses, and measured pleural fluid and serum levels of albumin, protein, LDH,
cholesterol, and bilirubin of 381 consecutive patients with pleural effusion. Seventy-one (23%) pleural effusions were transudates
and 236 were exudates. As a single criterion, the pleural fluid to serum albumin ratio >0.5 was the most accurate parameter
(88.4%). An albumin gradient of 12 g/l had an accuracy of 75% in the whole population but it detected 96% of transudative
effusions in patients treated with diuretics. Light’s criteria and abbreviated Light’s criteria had similar accuracies, 87.8%
vs. 88.2%, respectively. In conclusions, different alternatives can be used instead of Light’s criteria. |
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Keywords: | pleural effusions biochemical criteria exudates transudates thoracentesis |
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