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Pleural fluid pH in malignant effusions. Diagnostic, prognostic, and therapeutic implications
1Division of Pulmonary and Critical Care Medicine, Medical University of South Carolina, Charleston.
Annals of Internal Medicine
|March 1, 1988
Summary
Measuring pleural fluid pH in malignant effusions aids diagnosis and prognosis. Low pH indicates poorer survival and less effective tetracycline pleurodesis for these effusions.
Area of Science:
- Pulmonology
- Oncology
- Medical Diagnostics
Background:
- Malignant pleural effusions are common in advanced cancers.
- The diagnostic and prognostic value of pleural fluid pH is not well-established.
- Pleural fluid pH may influence treatment decisions for effusions.
Purpose of the Study:
- To evaluate the diagnostic utility of pleural fluid pH in malignant effusions.
- To determine if pleural fluid pH predicts patient survival.
- To assess the impact of pleural fluid pH on the response to chemical pleurodesis.
Main Methods:
- Prospective study comparing cytologic and biopsy results, survival, and pleurodesis response.
- Patients with normal (≥7.30) and low (<7.30) pH malignant effusions were analyzed.
- Twenty-one patients received tetracycline pleurodesis; outcomes were compared based on initial pH.
Main Results:
- Low-pH malignant effusions showed higher initial cytologic positivity.
- Patients with low-pH effusions had significantly shorter mean survival.
- Low-pH effusions responded less effectively to tetracycline pleurodesis.
Conclusions:
- Pleural fluid pH measurement offers valuable diagnostic information for malignant effusions.
- pH levels provide prognostic insights into survival.
- Pleural fluid pH guides palliative treatment strategies, including pleurodesis.
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