The Light Criteria: The Beginning and Why they are Useful 40 Years Later

Clinics in Chest Medicine

Volumn 34, Issue 1, 2013, Pages 21-26

  Light, Richard W ^a  

^a VANDERBILT UNIVERSITY MEDICAL CENTER   (United States)

Author keywords

Light criteria; Pleural effusion; Transudative effusion

Indexed keywords

AMINO TERMINAL PRO BRAIN NATRIURETIC PEPTIDE; CHOLESTEROL; DIURETIC AGENT; HYDROCHLOROTHIAZIDE; LACTATE DEHYDROGENASE; MERCURY CHLORIDE;

CHOLESTEROL BLOOD LEVEL; CONGESTIVE HEART FAILURE; DIFFERENTIAL DIAGNOSIS; DISEASE CLASSIFICATION; ERYTHROCYTE COUNT; HUMAN; HYDROTHORAX; LACTATE DEHYDROGENASE BLOOD LEVEL; LIGHT CRITERIA; PLEURA EFFUSION; PLEURA FLUID; PRIORITY JOURNAL; RESPIRATORY TRACT PARAMETERS; REVIEW; SENSITIVITY AND SPECIFICITY; SERUM PLEURAL FLUID ALBUMIN GRADIENT; THORACOCENTESIS;

DIAGNOSIS, DIFFERENTIAL; DIAGNOSTIC TECHNIQUES AND PROCEDURES; EXUDATES AND TRANSUDATES; HUMANS; LIGHT; PLEURAL EFFUSION;

EID: 84873605359     PISSN: 02725231     EISSN: 15578216     Source Type: Journal    
DOI: 10.1016/j.ccm.2012.11.006     Document Type: Review

References (35)

1. Light R.W., MacGregor M.I., Luchsinger P.C., et al. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med 1972, 77:507-514.
2. Holten K. Diagnostic value of some biochemical pleural fluid examinations. Scand J Respir Dis Suppl 1968, 63:121-125.
3. Wroblewski F., Wroblewski R. The clinical significant of lactic dehydrogenase activity of serous effusions. Ann Intern Med 1958, 48:813-822.
4. 2. Chest 1973, 64:591-596.
5. Carr D.T., Power M.H. Clinical value of measurements of protein in pleural fluid. N Engl J Med 1958, 259:926-927.
6. Light R.W., MacGregor M.I., Ball W.C., et al. Pleural fluid lactic acid dehydrogenases and protein content. Ann Intern Med 1972, 76:880.
7. Scheurich J.W., Keuer S.P., Graham D.Y. Pleural effusion: comparison of clinical judgment and Light's criteria in determining the cause. South Med J 1989, 82:1487-1491.
8. Light R.W. Pleural diseases 2007, Lippincott Williams and Wilkins, Baltimore (MD). 5th edition.
9. Hamm H., Brohan U., Bohmer R., et al. Cholesterol in pleural effusions: a diagnostic aid. Chest 1987, 92:296-302.
10. Valdés L., Pose A., Suarez J., et al. Cholesterol: a useful parameter for distinguishing between pleural exudates and transudates. Chest 1991, 99:1097-1102.
11. Costa M., Quiroga T., Cruz E. Measurement of pleural fluid cholesterol and lactate dehydrogenase. A simple and accurate set of indicators for separating exudates from transudates. Chest 1995, 108:1260-1263.
12. Vaz M.A., Teixeira L.R., Vargas F.S., et al. Relationship between pleural fluid and serum cholesterol levels. Chest 2001, 119:204-210.
13. Meisel S., Shamiss A., Thaler M., et al. Pleural fluid to serum bilirubin concentration ratio for the separation of transudates from exudates. Chest 1990, 98:141-144.
14. Yetkin O., Tek I., Kaya A., et al. A simple laboratory measurement for discrimination of transudative and exudative pleural effusion: pleural viscosity. Respir Med 2006, 100:1286-1290.
15. Papageorgiou E., Kostikas K., Kiropoulos T., et al. Increased oxidative stress in exudative pleural effusions: a new marker for the differentiation between exudates and transudates?. Chest 2005, 128:3291-3297.
16. Horvath L.L., Gallup R.A., Worley B.D., et al. Soluble leukocyte selectin in the analysis of pleural effusions. Chest 2001, 120:362-368.
17. Alexandrakis M.G., Kyriakou D., Alexandraki R., et al. Pleural interleukin-1beta in differentiating transudates and exudates: comparative analysis with other biochemical parameters. Respiration 2002, 69:201-206.
18. Uzun K., Vural H., Ozer F., et al. Diagnostic value of uric acid to differentiate transudates and exudates. Clin Chem Lab Med 2000, 38:661-665.
19. Garcia-Pachon E., Padilla-Navas I., Sanchez J.F., et al. Pleural fluid to serum cholinesterase ratio for the separation of transudates and exudates. Chest 1996, 110:97-101.
20. Romero S., Candela A., Martin C., et al. Evaluation of different criteria for the separation of pleural transudates from exudates. Chest 1993, 104:399-404.
21. Burgess L.J., Maritz F.J., Taljaard J.J. Comparative analysis of the biochemical parameters used to distinguish between pleural transudates and exudates. Chest 1995, 107:1604-1609.
22. Romero-Candeira S., Hernandez L., Romero-Brufao S., et al. Is it meaningful to use biochemical parameters to discriminate between transudative and exudative pleural effusions?. Chest 2002, 122:1524-1529.
23. Bielsa S., Porcel J.M., Castellote J., et al. Solving the Light's criteria misclassification rate of cardiac and hepatic transudates. Respirology 2012, 17:721-726.
24. Porcel J.M., Esquerda A., Martinez M., et al. Influence of pleural fluid red blood cell count on the misidentification of transudates. Med Clin (Barc) 2008, 131:770-772.
25. Romero-Candeira S., Fernandez C., Martin C., et al. Influence of diuretics on the concentration of proteins and other components of pleural transudates in patients with heart failure. Am J Med 2001, 110:681-686.
26. Heffner J.E., Sahn S.A., Brown L.K. Multilevel likelihood ratios for identifying exudative pleural effusion. Chest 2002, 121:1916-1920.
27. Pfister R., Schneider C.A. Natriuretic peptides BNP and NT-pro-BNP: established laboratory markers in clinical practice or just perspectives. Clin Chim Acta 2004, 349:25-38.
28. Porcel J.M., Vives M., Cao G., et al. Measurement of pro-brain natriuretic peptide in pleural fluid for the diagnosis of pleural effusions due to heart failure. Am J Med 2004, 116:417-420.
29. Liao H., Na M.J., Dikensoy O., et al. The diagnostic value of pleural fluid NT-proBNP levels in patients with cardiovascular diseases. Respirology 2008, 13:53-57.
30. Janda S., Swiston J. Diagnostic accuracy of pleural fluid NT-pro-BNP for pleural effusions of cardiac origin: a systematic review and meta-analysis. BMC Pulm Med 2010, 10:58.
31. Han C.H., Choi J.E., Chung J.H. Clinical utility of pleural fluid NT-pro brain natriuretic peptide (NT-proBNP) in patients with pleural effusions. Intern Med 2008, 47:1669-1674.
32. Kolditz M., Halank M., Schiemanck S., et al. High diagnostic accuracy of NT-proBNP for cardiac origin of pleural effusions. Eur Respir J 2006, 28:144-150.
33. Porcel J.M., Martínez-Alonso M., Cao G., et al. Biomarkers of heart failure in pleural fluid. Chest 2009, 136:671-677.
34. Porcel J.M. Utilization of B-type natriuretic peptide and NT-proBNP in the diagnosis of pleural effusions due to heart failure. Curr Opin Pulm Med 2011, 17:215-219.
35. Long A.C., O'Neal H.R., Peng S., et al. Comparison of pleural fluid N-terminal pro-brain natriuretic peptide and brain natriuretic-32 peptide levels. Chest 2010, 137:1369-1374.