#transudate

[cluelessmedic]

Pleural Effusion - fluid in the pleural space

Can be divided in to transudates and exudates, depending on protein concentration in the fluid. Draw of a diagnostic tap (10-30ml)

Exudates - protein >35g/L 

Infection - pneumonia, TB

Inflammation - PE, pancreatitis, rheumatoid, lupus

Malignancy - lung, mets, mesothelioma, lymphoma

To help remember the difference I like to think of an exudate as an exuding wound with lots of INFLAMMATION 

Transudates - protein <25g/L

increased venous pressure - cardiac failure, fluid overload

low protein - cirrhosis, nephrotic syndrome, malabsorption

Others e.g. hypothyroidism, Meigs' syndrome

If between 25-35g/L then apply Light's Criteria, this compares the protein level to serum levels

[drabc-blog-blog]

Causes of Pleural Effusion: transudates and exudates

We perform an aspirate of the pleural fluid to investigate the cause of pleural effusion.

Transudate (<30g/L protein, fluid LDH:serum LDH ratio >0.6): pneumonia, lung carcinoma, pulmonary infarct, TB, connective tissue disease

Exudate (>30g/L protein, fluid LDH:serum LDH ratio >0.6): pneumonia, lung carcinoma, pulmonary infarct, TB, connective tissue disease

Source - Stather et al. Complete SAQs for Medical Finals. 2010. Wiley-Blackwell publishing.