Identifying transudates misclassified by Light's criteria

Current Opinion in Pulmonary Medicine

Volumn 19, Issue 4, 2013, Pages 362-367

  Porcel, José M ^a  

^a HOSPITAL ARNAU DE VILANOVA   (Spain)

Author keywords

albumin gradient; exudates; heart failure; hepatic hydrothorax; natriuretic peptides; transudate

Indexed keywords

LACTATE DEHYDROGENASE; NATRIURETIC FACTOR; SERUM ALBUMIN;

ALBUMIN BLOOD LEVEL; BAYES THEOREM; DIAGNOSTIC ERROR; DIFFERENTIAL DIAGNOSIS; HEART FAILURE; HUMAN; LACTATE DEHYDROGENASE BLOOD LEVEL; LIGHT CRITERIA; LIVER CIRRHOSIS; NAMED INVENTORIES, QUESTIONNAIRES AND RATING SCALES; PLEURA FLUID; REVIEW;

EXUDATES AND TRANSUDATES; FEMALE; HEART FAILURE; HUMANS; HYDROTHORAX; L-LACTATE DEHYDROGENASE; MALE; NATRIURETIC PEPTIDE, BRAIN; PEPTIDE FRAGMENTS; PLEURAL EFFUSION; REPRODUCIBILITY OF RESULTS; SERUM ALBUMIN; STAINING AND LABELING;

EID: 84879925601     PISSN: 10705287     EISSN: 15316971     Source Type: Journal    
DOI: 10.1097/MCP.0b013e32836022dc     Document Type: Review

References (24)

1. Light RW. Pleural diseases, 6th ed, Philadelphia: Lippincott Williams Wilkins; 2013.
2. Porcel JM, Light RW. Pleural effusions. Dis Mon 2013; 59:29-57.
3. Light RW, Macgregor MI, Luchsinger PC, et al. Pleural effusions: the diagnostic separation of transudates and exudates. Ann Intern Med 1972; 77:507-513.
4. Porcel JM, Pena JM, Vicente de Vera C, et al. Reappraisal of the standard method (Light's criteria) for identifying pleural exudates. Med Clin (Barc) 2006; 126:211-213.
5. Porcel JM. Pearls and myths in pleural fluid analysis. Respirology 2011; 16:44-52.
6. Heffner JE. Evaluating diagnostic tests in the pleural space. Differentiating transudates from exudates as a model. Clin Chest Med 1998; 19:277-293.
7. Bielsa S, Porcel JM, Castellote J, et al. Solving the Light's criteria misclassification rate of cardiac and hepatic transudates. Respirology 2012; 17:721-726.
8. Romero-Candeira S, Hernández L. The separation of transudates and exudates with particular reference to the protein gradient. Curr Opin Pulm Med 2004; 10:294-298.
9. Porcel JM, Esquerda A, Marti'nez M, et al. Influence of pleural fluid red blood cell count on the misidentification of transudates. Med Clin (Barc) 2008; 131:770-772.
10. Romero-Candeira S, Hernández 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.
11. Heffner JE, Highland K, Brown LK. A meta-analysis derivation of continuous likelihood ratios for diagnosing pleural fluid exudates. Am J Respir Crit Care Med 2003; 167:1591-1599.
12. Porcel JM, Pena JM, Vicente de Vera MC, et al. Bayesian analysis using continuous likelihood ratios for identifying pleural exudates. Respir Med 2006; 100:1960-1965.
13. Roth BJ, O'Meara TF, Cragun WH. The serum-effusion albumin gradient in the evaluation of pleural effusions. Chest 1990; 98:546-549.
14. Akkurt I, Copur AS, Samurkasoglu AB, et al. The serum-effusion albumin gradient in the evaluation of pleural effusions. Chest 1993; 103:1634-1635.
15. Burgess LJ, Maritz FJ, Taljaard JJF. Comparative analysis of the biochemical parameters used to distinguish between pleural transudates and exudates. Chest 1995; 107:1604-1609.
16. Gonlugur U, Gonlugur TE. The distinction between transudates. J Biomed Sci 2005; 12:985-990.
17. Han CH, Choi JE, Chung JH. Clinical utility of pleural fluid NT-probrain natriuretic peptide in patients with pleural effusions. Intern Med 2008; 47:1669-1674.
18. Bayram M, Ozkan G, Oztekin E, et al. Role of serum and pleural fluid NT-proBNP levels in identifying pleural effusion due to heart failure. Multidisciplinary Respir Med 2009; 4:175-181.
19. Porcel JM. 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.
20. 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.
21. Porcel JM, 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.
22. Porcel JM, Chorda J, Cao G, et al. Comparing serum and pleural fluid probrain natriuretic peptide (NT-proBNP) levels with pleural-to-serum albumin gradient for the identification of cardiac effusions misclassified by Light's criteria. Respirology 2007; 12:654-659.
23. Porcel JM, Marti'nez-Alonso M, Cao G, et al. Biomarkers of heart failure in pleural fluid. Chest 2009; 136:671-677.
24. Porcel JM, Bielsa S, Morales JL, et al. Comparison of pleural N-terminal pro-B-type natriuretic peptide, midregion pro-atrial natriuretic peptide and midregion pro-adrenomedullin for the diagnosis of pleural effusions associated with cardiac failure. Respirology 2013 (in press). doi: 10.1111/resp. 12039.