Chest
Selected ReportsDiagnostically Significant Variations in Pleural Fluid pH in Loculated Parapneumonic Effusions
Section snippets
Materials and Methods
We prospectively measured pleural fluid characteristics from seven consecutive patients with complicated parapneumonic effusions presenting to our respiratory unit (Oxford Centre for Respiratory Medicine, Oxford) over an 8-month period (December 2001 to August 2002). Patients are referred to the Oxford unit directly from general practitioners (60%), from other local hospital consultants (30%), and occasionally from respiratory consultants in other neighboring health authorities (< 10%).
Patients
Results
The seven patients studied had a median age of 67 years (range, 32 to 83 years). Four patients were men, and three patients were women, and they all presented with community-acquired complicated parapneumonic effusions. Five patients had received antibiotics prior to hospital admission. None had a medical history of pleural disease or cancer. Blood culture specimens were obtained in all cases, and all results were negative. Pleural fluid cytology was negative for malignancy in all cases.
The
Conclusions
We believe this is the first reported series of variation in pleural pH between different locules in complicated parapneumonic effusions. These variations are large, clinically important, and cast light on the mechanisms predominantly responsible for the acidosis seen in infected effusions.
In three of our patients, if only the first pleural fluid sample had been obtained showing the recorded pleural pH of > 7.2, it would have implied that they probably did not require chest tube drainage,
References (11)
- et al.
Parapneumonic effusions
Am J Med
(1980) - et al.
Low pleural fluid pH in parapneumonic effusion [letter]
Chest
(1975) - et al.
Diagnostic significance of pleural fluid pH and Pco2
Chest
(1973) - et al.
The glucose-pH relationship in parapneumonic effusions
Arch Intern Med
(1978) - et al.
Medical and surgical treatment of parapneumonic effusions: an evidence-based guideline
Chest
(2000)
Cited by (0)
Mr. Maskell is partly funded by a Medical Research Council (UK) grant.