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Pleural fluid: analysis
Overview
- The pleural cavity normally contains only a small amount of fluid; little or no fluid can be obtained by aspiration unless excess fluid (pleural effusion Pleural: effusion ) is present.
- Gross appearance of the fluid can provide information which may assist in determining the nature of the fluid, eg a milky solution may be chylous.
- Investigation of effusions commonly includes some or all of the following:
- Cell counts Peritoneal fluid: differential cell count.
- Refractometry for total protein Pleural fluid: protein.
- Cytology Pleural fluid: cytology.
- Culture Pleural fluid: culture and sensitivity.
- Additional biochemical analyses may be of benefit for further characterization. Aim to classify effusion initially into:
- Transudate.
- Modified transudate.
- Exudate.
Uses
Alone
- Assessment of nature pleural fluid; physical character, protein content, cell count, cytology, biochemistry, microbiology to aid in evaluation of cause of effusion.
Sampling
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Tests
Methodologies
Physical character
- Color.
- Turbidity.
- Coagulation.
- Odor.
- If the effusion is hemorrhagic, PCV Hematology: packed cell volume should be performed on the fluid.
Biochemistry
- To determine:
- Protein content.
- Presence of lipids (triglycerides and cholesterol).
- Cytology Pleural fluid: cytology.
- Cell count and differential Pleural fluid: differential cell count.
- Culture and sensitivity Pleural fluid: culture and sensitivity.
Availability
- Readily available.
Technique intrinsic limitations
- Does not always reveal underlying cause of effusion.
Technician extrinsic limitations
- Cytological interpretation may be difficult, especially in differentiating neoplasia from reactive mesothelial cells - send for expert analysis.
Result Data
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Further Reading
Publications
Refereed papers
- Recent references from VetMedResource and PubMed.
- Tyler R D et al (1989) Evaluation of pleural and peritoneal effusions. Vet Clin North Am Small Anim Pract 19 (4), 743-768.