Pleural fluid and srum alb n ldh

Hi all
I wanted to know why we get serum albumin and ldh done when we do a pleural fuild analysis. Is there any correlation between the two?

[Jack54]

Is albumin gradient or fluid to serum albumin ratio better than the pleural fluid lactate dehydroginase in the diagnostic of separation of pleural effusion?
Background
To determine the accuracy of serum-effusion albumin gradient (SEAG) and pleural fluid to serum albumin ratio (ALBR) in the diagnostic separation of pleural effusion into transudate and exudate and to compare SEAG and ALBR with pleural fluid LDH (FLDH) the most widely used test.
Methods
Data collected from 200 consecutive patients with a known cause of pleural effusion in a United Kingdom district general hospital.
ResultsThe median and inter quartile ranges (IQR) for SEAG 93.5 (33.8 to 122.5) g/dl, ALBR 0.49 (0.42 to 0.62) and FLDH 98.5 IU/L(76.8 to 127.5) in transudates were significantly lower than the corresponding values for exudates 308.5 (171 to 692), 0.77 (0.63 to 0.85), 344 (216 to 695) all p < 0.0001. The Area Under the Curve (AUC) with 95% confidence intervals (Cl) for SEAG, ALBR and FLDH were 0.81 (0.75 to 0.87), 0.79 (0.72 to 0.86) and 0.9 (0.87 to 0.96) respectively. The positive likelihood ratios with 95%CI for FLDH, SEAG, and ALBR were: 7.3(3.5–17), 6.3(3–15) 6.2(3–14) respectively. There was a significant negative correlation between SEAG and ALBR (r= -0.89, p < 0.0001).
ConclusionThe discriminative value for SEAG and ALBR appears to be similar in the diagnostic separation of transudates and exudates. FLDH is a superior test compared to SEAG and ALBR.
Patients referred for evaluation of pleural effusion to the respiratory unit at Rotherham Trust hospital, United Kingdom, from January 1989 to June 1991 for a prospective investigation of the dynamics of pleural effusion formation and removal were included in the study [8]. The cause of pleural effusion and their diagnostic separation was determined using clinical criteria set by Light and associates [4]. All patients were followed for at least 3 months or till the final cause of the pleural effusion was established. During the study, pleural effusion samples from two hundred and twelve (212) consecutive patients were collected. However, eight patients with uncertain diagnosis and four patients with possible multiple causes for the pleural effusion were excluded from the analysis. Effusions due to pulmonary embolism were classified as exudates according to Burgess et al [6].
Blood and pleural effusion samples collected and stored at -80°C were analyzed within a period of six months for albumin, total protein and LDH level. The pleural fluid and the corresponding serum samples were drawn simultaneously at the time of admission before any treatment was administered. LDH was measured with Boehringer Mannheim kit according to established methods and results expressed in IU/L [9]. The upper limit for the normal serum LDH value in our laboratory during the study was 200 IU/L. SEAG was calculated by subtracting the pleural fluid albumin value from serum albumin value.

[jim62]

Bet you can't say that in english !

Rodney B. Incredulous

[whineyhiney]

so it is to determine the transudates from the exudates?  or intra pulmonary from extrapulmonary? infection vs cancer?  systemic vs pneumonia?  just wondering.  interesting.  I learn something new everyday.

[jim62]

Yep, that's it, all right !!

Ralph

[FLBrat]

Huh?

[viennaustria]

I donunderstandawordyosayin...:)

[Jack54]

This is 10th grade stuff in Alabamy. We jest natually like this decoriculum. I think Hiney may be from Alabamy, but was ne'er told?

[degrassi]

we learned that stuff at Degrassi High too.  :)