Pleural Fluid Analysis

Pleural Fluid Analysis is a topic covered in the Davis's Lab & Diagnostic Tests.

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Synonym/Acronym:
Thoracentesis fluid analysis.

Rationale
To assess and categorize fluid obtained from within the pleural space for infection, cancer, and blood as well as identify the cause of its accumulation.

Patient Preparation
There are no food, fluid, or activity restrictions unless by medical direction. Regarding the patient's risk for bleeding, the patient should be instructed to avoid taking natural products and medications with known anticoagulant, antiplatelet, or thrombolytic properties or to reduce dosage, as ordered, prior to the procedure. Number of days to withhold medication is dependent on the type of anticoagulant. Note the last time and dose of medication taken.

Normal Findings
Method: Spectrophotometry for amylase, cholesterol, glucose, lactate dehydrogenase (LDH), protein, and triglycerides; ion-selective electrode for pH; automated or manual cell count; macroscopic and microscopic examination of cultured microorganisms; microscopic examination of specimen for microbiology and cytology.

AppearanceClear
Color Pale yellow
AmylaseParallels serum values
CholesterolParallels serum values
CEAParallels serum values
GlucoseParallels serum values
LDHLess than 2/3 the upper limit of normal serum LDH
Fluid LDH–to–serum LDH ratio0.6 or less
Protein3 g/dL
Fluid protein–to–serum protein ratio0.5 or less
TriglyceridesParallel serum values
pH7.37–7.43
RBC countNone seen
WBC countLess than 1,000 cells/microL
CultureNo growth
Gram stainNo organisms seen
CytologyNo abnormal cells seen
CEA = carcinoembryonic antigen; LDH = lactate dehydrogenase; RBC = red blood cell; WBC = white blood cell.

Critical Findings and Potential Interventions

  • Positive culture findings in any sterile body fluid.

Timely notification to the requesting health-care provider (HCP) of any critical findings and related symptoms is a role expectation of the professional nurse. A listing of these findings varies among facilities.

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