Comparative Analysis and Evaluation of Pleural Fluid Biochemical Parameter with Cholesterol to Differentiate Transudates from Exudates- A Study in Uttar Pradesh Region

Differentiation of Transudates from Exudates

Abstract

Background: Pleural fluid (PF) is ultra filtered plasma formed by the parietal pleura and reabsorbed by visceral pleura in a unremitting process. The mean quantity of pleural fluid (PF) present in normal state is as small as 8.44.3ml. Based on the fundamental pathological abnormality and method of formation, effusions may be either transudates or exudates. Therefore, differentiating the pleural fluid either as transudates or exudates is an significant step in the assessment of pleural effusions. Objective: To find the analytical value of pleural fluid Cholesterol and Lactate dehydrogenase in differentiating exudate and transudate effusion compared to Lights criteria. Subjects and Methods: A total number of 150 adult patients of both sex having pleural effusions substantiate through radiological investigations; chest x ray and ultra-sonogram were taken into this study. Pleural fluid cholesterol of more than 45mg/dl and LDH of more than 200IU/L was taken as cut off value and presence of any one or both constraint is diagnosed as exudates. And other reference values meeting the Lights criteria for exudate is regard as  exudate pleural fluid. Results: Statistically significant disparity were observed in mean pleural fluid protein and LDH, i.e, exudates (5.11.4, 3468 IU/L) and transudates (3.11.7, 1296 IU/L) respectively p<0.007. Sugar value also shows a significant difference between transudates and exudates (813 mg/dl) and (378 mg/dl) respectively P< 0.001. On the other hand single parameter, i.e, total Cholesterol level shows a statistical significant difference between exudates and transudates value (789 mg/dl), (314 mg/dl) respectively. P<0.003 Which has been used to classify pleural effusion and was extremely reliable in explain the type of fluid. Conclusion: Thus, the present study shows the utility of total cholesterol in classifying transudate from exudates fluid. According to the result of this study we can consider, only the measurement of total fluid cholesterol can play a imperative role in classifying transudates from exudates fluid. The major precincts of this study are the small numbers of patients and all adult individual as a study subject. The results of this present study need to be established in additional studies with large sample size and bearing in mind the different age group of the patients.