2008
DOI: 10.1164/rccm.200801-062oc
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Clinically Important Factors Influencing the Diagnostic Measurement of Pleural Fluid pH and Glucose

Abstract: Rationale: Accurate pleural fluid pH and glucose measurement is a key component in the diagnosis and management of patients with pleural effusion. Standardized methods of pleural fluid collection have not been defined. Objectives: To assess the effect of common clinical factors that may distort measurement accuracy of pleural fluid pH and glucose. Methods: Ninety-two exudative pleural aspirates were collected in commercially available blood gas syringes. Measurements and Main Results: Samples were analyzed imm… Show more

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citations
Cited by 94 publications
(65 citation statements)
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References 27 publications
(25 reference statements)
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“…Efforts must be made to ensure fluid is collected anaerobically, placed in ice and analysed within 1 hour to minimise alteration of the pH by external factors such as air and pCO2. Similarly Lidocaine can falsely reduce the pleural pH, even with volumes as small as 0.2ml (Rahman et al, 2008). Heparin was also found to lower pleural fluid pH.…”
Section: Exudates Transudatesmentioning
confidence: 95%
See 1 more Smart Citation
“…Efforts must be made to ensure fluid is collected anaerobically, placed in ice and analysed within 1 hour to minimise alteration of the pH by external factors such as air and pCO2. Similarly Lidocaine can falsely reduce the pleural pH, even with volumes as small as 0.2ml (Rahman et al, 2008). Heparin was also found to lower pleural fluid pH.…”
Section: Exudates Transudatesmentioning
confidence: 95%
“…A glucose level of < 3.4mmol/l is sufficiently low to raise concerns of conditions such as complicated parapneumonic effusions, rheumatoid effusions, malignancy and tuberculous effusions (5). Glucose measurements are less vulnerable to the effects of air, Lignocaine and delayed processing (Rahman et al, 2008).…”
Section: Glucosementioning
confidence: 99%
“…This manoeuvre does not cause a clinically relevant increase in pH, provided care is taken to avoid significant exposure to air (6). Nor is it necessary to pack the fluid sample in ice, as long as the pH determination is performed within 4 hours following extraction (7,8). Ideally, the measurement should be obtained using a blood gas machine.…”
Section: öZetmentioning
confidence: 99%
“…Factors influencing pleural fluid pH have less effect on glucose concentration, suggesting that the latter can be used as an acceptable alternative to the former (8).…”
Section: öZetmentioning
confidence: 99%
“…Unfortunately fluid pH may be strongly influenced by sampling errors such as delay in analysis and air or lignocaine in the sampling syringe. 4 Should patients with empyema initially be managed conservatively or surgically? A conservative approach is advocated if sepsis settles promptly with antibiotics, regardless of radiological improvement.…”
Section: Respiratory Infectionmentioning
confidence: 99%