Role of biochemical tests in the diagnosis of large pericardial effusions
Date
2002
Authors
Burgess L.J.
Reuter H.
Taljaard J.J.F.
Doubell A.F.
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Abstract
Study objectives: To determine the biochemical characteristics of large pericardial effusions in various disease states, and to assess their utility as diagnostic tools. Setting: An academic university hospital in the Western Cape, South Africa. Design: Consecutive, prospective case series. Patients: One hundred ten hospital patients > 12 years old, who presented to the echocardiography department with large pericardial effusions, and 12 control subjects who underwent open-heart surgery (coronary artery bypass graft or aortic valve replacement). Measurements: Fluid was sent for examination of biochemistry, adenosine deaminase, microbiology, hematology, and cytology. The etiology of each pericardial fluid sample was established using predetermined criteria. Results: The biochemistry of pericardial exudates differed significantly from pericardial transudates. Light's criteria (whereby an exudate is defined as having one or more of the following: pleural fluid/serum protein ratio > 0.5; pleural fluid/serum lactate dehydrogenase [LDH] ratio > 0.6; and/or pleural fluid LDH level > 200 U/L) were applied to pericardial fluids and demonstrated to be the most reliable diagnostic tool for identifying pericardial exudates. The corresponding sensitivity was 98%. Conclusion: Although laboratory tests are a useful guideline when assessing the etiology and pathophysiology of pericardial effusions, the majority of large, clinically significant pericardial effusions result from exudative causes.
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Keywords
adenosine deaminase, lactate dehydrogenase, protein, adolescent, adult, aged, aorta valve replacement, article, aspiration cytology, blood analysis, chemical analysis, clinical trial, controlled clinical trial, controlled study, coronary artery bypass graft, diagnostic accuracy, exudate, human, lactate dehydrogenase blood level, major clinical study, microbiological examination, pathophysiology, pericardial effusion, pleura fluid, practice guideline, priority journal, protein blood level, tissue level, Bilirubin, Cholesterol, Humans, L-Lactate Dehydrogenase, Pericardial Effusion, Prospective Studies
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