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Pleural fluid parameters identifying complicated parapneumonic effusions.

D Jiménez Castro1, G Díaz Nuevo, A Sueiro

  • 1Respiratory Department, Hospital Ramón y Cajal, Alcalá de Henares University, Madrid, Spain. djc_69_98@yahoo.com

Respiration; International Review of Thoracic Diseases
|August 10, 2005
PubMed
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Pleural fluid pH is the most accurate predictor of complicated parapneumonic effusions requiring drainage, with an optimal threshold of 7.15. Continuous likelihood ratios offer more information than binary ones for assessing effusion complications.

Area of Science:

  • Pulmonology
  • Critical Care Medicine
  • Thoracic Surgery

Background:

  • Clinical utility of pleural fluid parameters for complicated parapneumonic effusions is debated.
  • Parapneumonic effusions often require drainage, necessitating accurate prognostic tools.

Purpose of the Study:

  • To evaluate pleural fluid parameters in predicting complicated parapneumonic effusions.
  • To establish optimal decision thresholds for intervention.

Main Methods:

  • Prospective study of 238 patients with parapneumonic effusions.
  • Diagnostic thoracentesis was performed.
  • Analysis of pleural fluid pH, glucose, LDH, and volume.

Main Results:

  • Pleural fluid pH demonstrated the highest diagnostic accuracy (AUC: 0.928).

Related Experiment Videos

  • Optimal pH threshold for drainage was identified as 7.15.
  • Continuous likelihood ratios provided more information than binary ones.

    • Conclusions:

    • Pleural fluid pH is a highly accurate marker for complicated parapneumonic effusions.
    • A pH threshold of 7.15 indicates the need for chest drainage.
    • Continuous likelihood ratios are recommended for assessing complication probability; LDH is not an independent predictor.