Do we measure pleural fluid pH correctly?

Putnam, Benjamin; Elahi, Azeem; Bowling, Mark R.

doi:10.1097/mcp.0b013e3283620844

Cited by 8 publications

(7 citation statements)

References 30 publications

(39 reference statements)

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“…The accurate method of measuring pleural fluid pH level is through the blood gas analyzer rather than the pH meter, pH indicator stick, and litmus paper. But, the gross pus should be avoided when using the blood gas analyzer22. Exposures to local anesthetic (lidocaine) or heparin in the syringe decreases pH levels of pleural fluid.…”

Section: Analysis Of Pleural Fluidmentioning

confidence: 99%

Diagnostic Tools of Pleural Effusion

2014

Tuberc Respir Dis

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Pleural effusion is not a rare disease in Korea. The diagnosis of pleural effusion is very difficult, even though the patients often complain of typical symptoms indicating of pleural diseases. Pleural effusion is characterized by the pleural cavity filled with transudative or exudative pleural fluids, and it is developed by various etiologies. The presence of pleural effusion can be confirmed by radiological studies including simple chest radiography, ultrasonography, or computed tomography. Identifying the causes of pleural effusions by pleural fluid analysis is essential for proper treatments. This review article provides information on the diagnostic approaches of pleural effusions and further suggested ways to confirm their various etiologies, by using the most recent journals for references.

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Section: Analysis Of Pleural Fluidmentioning

confidence: 99%

Diagnostic Tools of Pleural Effusion

2014

Tuberc Respir Dis

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“…Indeed, normal pleural pH is 7.6, transudates' pH is 7.4-7.55, whereas exudates' pH is 7.3-7.45. A pH < 7.3 could be found in case of empyema, cancer, TBC or esophagus rupture 13 . Sometimes, pH > 7.6 is found in infections caused by Proteus species 14 .…”

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confidence: 99%

Integration of voltammetric analysis, protein electrophoresis and pH measurement for diagnosis of pleural effusions: a non-conventional diagnostic approach

Pipita

Santonico

Pennazza

et al. 2020

Sci Rep

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Pleural effusion is very common, but an etiologic diagnosis is often difficult. We used three unconventional diagnostic techniques (voltammetric analysis, protein electrophoresis and pH measurement) performed on pleural effusion to do a preliminary distinction between a neoplastic and a non-neoplastic origin. Pleural fluid samples were collected through thoracentesis, thoracoscopy, or post-surgery pleural drainage of 116 patients admitted to acute care wards. Samples were analyzed with the three unconventional techniques: voltammetric analysis using the BIONOTE system, capillary electrophoresis and pH measurement using a potentiometric method. The BIONOTE system is an innovative system that performs a cyclic voltammetric analysis of a biological liquid sample. The final output of the electrochemical analysis is an electrical pattern that represents a fingerprint of the analyzed sample and each sample has a different fingerprint. Data from the three unconventional diagnostic techniques were analyzed using partial least squares discriminant analysis to discriminate neoplastic from non-neoplastic effusions; we also evaluated sensitivity, specificity and percentage of correct classification. The mean age was 68 years (SD: 12); 78 (67.24%) participants were men. Results obtained from all the unconventional techniques employed showed that neoplastic and non-neoplastic pleural effusions were correctly classified in 80.2% of cases, with a sensitivity of 77% and specificity of 83%. The combined use of voltammetric analysis, protein electrophoresis and pH measurement of pleural fluid can easily and quickly distinguish a neoplastic from a non-neoplastic pleural effusion with reliable accuracy and represents an innovative diagnostic approach. In fact, this protocol can be executed in just few minutes directly in the patient's bed and it holds great promise to improve the prognosis and therapeutic chances.

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“…Pleural effusion is the pathological accumulation of pleural fluid resulting from excess fluid production and/or increased transpleural pressure, increased capillary permeability, and impaired lymphatic drainage [1], [2]. And it occurs in many pulmonary or systemic diseases such as infection, liver cirrhosis, congestive heart failure, and malignancy [1], [2], [3], [4].…”

Section: Introductionmentioning

confidence: 99%

“…For assessment and differential diagnosis of the cause of pleural effusion, pleural fluid pH is one of the most useful indicators [4], [5], [6], [7], [8], along with the widely recommended indicators such as total protein, lactate dehydrogenase, and glucose levels. Pleural fluid pH greater than 7.30 is associated with uncomplicated effusion [2], [4], [6], [8], [9] and that less than 7.20 is associated with complicated parapneumonic effusion (CPPE), requiring chest tube drainage [1], [5], [8], [10]. Hence, accurate measurement of pleural fluid pH is important.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of analytical performance of i-Smart 300 and pHOx ultra for the accurate determination of pleural fluid pH

Cho

Kim

et al. 2019

Practical Laboratory Medicine

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Background Pleural fluid pH is an essential test for diagnosing complicated parapneumonic effusion. We evaluated the performance of two blood gas analyzers in measuring pleural fluid pH. Methods The i-STAT G3+ (Abbott) was used as a reference analyzer to evaluate the pH values obtained from other methods: the i-Smart 300 (i-SENS), the pHOx Ultra (Nova Biomedical), using a clot catcher to filter off microclot, and pH indicator paper. Within-device precision was performed using quality control materials. We compared pleural fluid pH (n = 86) by the above methods and analyzed the concordance rate at the level of the medical decision point, pH 7.2. Results The within-device coefficient of variations of pH were below 0.1% for all blood gas analyzers tested. The slopes of the regression equations for the i-Smart 300, pHOx Ultra, and pH indicator paper against the reference analyzer were 0.850 (95% confidence interval, CI, 0.800–0.896), 0.714 (95% CI, 0.671–0.766), and 1.105 (95% CI, 0.781–1.581), respectively. The kappa values for the i-Smart 300, pHOx Ultra, and pH indicator paper against the reference analyzer were 0.883 (95% CI, 0.656–1.110), 0.739 (95% CI, 0.393–1.084), and 0.464 (95% CI, 0.102–0.826), respectively. Conclusions The i-Smart 300 and pHOx Ultra demonstrated good analytical performance and diagnostic accuracy when determining pleural fluid pH compared with that by the i-STAT G3+, whereas the pH indicator paper showed unsatisfactory results.

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Do we measure pleural fluid pH correctly?

Cited by 8 publications

References 30 publications

Diagnostic Tools of Pleural Effusion

Diagnostic Tools of Pleural Effusion

Integration of voltammetric analysis, protein electrophoresis and pH measurement for diagnosis of pleural effusions: a non-conventional diagnostic approach

Comparison of analytical performance of i-Smart 300 and pHOx ultra for the accurate determination of pleural fluid pH

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