Could pleural fluid lactate level have an added diagnostic value in para pneumonic effusion?

IF 0.2 Q4 RESPIRATORY SYSTEM
Mohammed Shehta, A. Fathy, Mohammed Ibrahim
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引用次数: 0

Abstract

Background Pleural effusion is the accumulation of fluid in the pleural space, can be classified into transudative and exudative effusion. A parapneumonic effusion is a pleural effusion that forms adjacent to pneumonia. Para pneumonic effusion can be sub-typed into uncomplicated and complicated effusion. The aim of our work was to identify accuracy of pleural fluid lactate level to discriminate transudative from exudative effusion and uncomplicated from complicated parapneumonic effusion. Methods Thoracocentesis was done with subsequent evaluation of pleural fluid PH, protein, LDH, glucose and lactate. Also, gram stain, microbiological cultures, cytological examination was performed. Medical thoracoscopy was done whenever indicated. Results Our study included 52 males and 38 females with mean age 57.14 ± 11.69 years. Transudative effusions were detected in 22 patients (24.4%). Parapneumonic effusions accounted for 39 cases (43.3%), of these 23 cases were uncomplicated and 16 cases were complicated. The median pleural fluid lactate level in exudative effusion was significantly higher than transudative effusion (P value<0.001), in complicated parapneumonic effusion was significantly higher than uncomplicated parapneumonic effusion (P value<0.001). Pleural fluid lactate cut-off value of 2.68 mmol/l or more yielded 97% sensitivity, 90.9% specificity for detection of exudative effusion (Auc 0.968). A cut of value of 6.22 mmol/l had 87.5% sensitivity, 91.3% specificity for detection of complicated parapneumonic effusion. (Auc 0.971). Conclusion The pleural fluid lactate level has a high accuracy to discriminate transudative from exudative pleural effusion and uncomplicated from complicated parapneumonic effusion.
胸膜液乳酸水平对肺旁积液有额外的诊断价值吗?
背景:胸腔积液是胸腔内积液,可分为渗出性积液和透出性积液。肺旁积液是在肺炎附近形成的胸腔积液。肺旁积液可分为简单积液和复杂积液。我们的工作的目的是确定胸膜液乳酸水平的准确性,以区分渗出性积液和非复杂性和复杂的肺旁积液。方法行胸刺针穿刺,测定胸腔积液PH、蛋白、乳酸脱氢酶、葡萄糖、乳酸。同时进行革兰氏染色、微生物培养、细胞学检查。只要有指示,就进行医学胸腔镜检查。结果男性52例,女性38例,平均年龄57.14±11.69岁。22例(24.4%)患者检出经囊性积液。肺旁积液39例(43.3%),其中无并发症23例,合并并发症16例。渗出性胸腔积液中位胸膜乳酸水平显著高于转诊性胸腔积液(P值<0.001),复杂性肺旁积液中位胸膜乳酸水平显著高于非复杂性肺旁积液(P值<0.001)。胸膜液乳酸截断值为2.68 mmol/l及以上时,检测渗出性积液的敏感性为97%,特异性为90.9% (Auc 0.968)。6.22 mmol/l的切口值对并发肺旁积液的检测敏感性为87.5%,特异性为91.3%。0.971 (Auc)。结论胸膜液乳酸水平对单纯性与渗出性胸膜积液、单纯性与复杂性肺旁积液鉴别具有较高的准确性。
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来源期刊
自引率
0.00%
发文量
46
审稿时长
22 weeks
期刊介绍: The journal will cover technical and clinical studies related to health, ethical and social issues in field of The Egyptian Journal of Chest Diseases and Tuberculosis aims to publish and inform readers and all chest physicians of the progress in medical research concerning all aspect of chest diseases. Publications include original articles review articles, editorials, case studies and reports which are relevant to chest diseases. The Journal also aims to highlight recent updates in chest medicine. . Articles with clinical interest and implications will be given preference.
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