Diagnostic value of pleural fluid obtained from a chest tube collection system.
Diagnostic value of pleural fluid obtained from a chest tube collection system.
复制标题
从胸管收集系统获得的胸水的诊断价值。
DOI：
10.1007/s00408-014-9666-6
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发表时间：
2015
期刊：
影响因子：
5
通讯作者：
McCurdy,MichaelT
中科院分区：
文献类型：
--
作者：
Reed,RobertM;Eberlein,Michael;Netzer,Giora;Pickering,Edward;Shanholtz,Carl;Verceles,AvelinoC;McCurdy,MichaelT
背景胸腔积液通常直接从胸膜腔抽取用于诊断研究，但当胸管已经就位且传统方法不可行时，偶尔需要进行分析。胸管插入后从胸腔积液收集系统获得的液体样本分析的诊断价值是unknown.MethodsWe进行了前瞻性观察研究的患者中，胸管放置计划的临床指征。进行诊断研究，从胸膜腔获得的液体在插入管的时间，然后重复2，6，和24小时后，从液体收集system.Results55%的23个积液研究的样本符合光的标准渗出在基线。乳酸脱氢酶（LDH）随时间推移与基线测量值的差异很大，24 h时只有25%的测量值在基线水平的25%范围内。LDH对渗出液的敏感性仍为100%，重复测量的特异性范围为50- 69%。总蛋白表现出较小的变异性，24 h时85%的测量值在基线测量值的25%范围内。24 h的敏感性和特异性分别为88%和82%。胆固醇、白蛋白和甘油三酯的重复测量通常与基线值相关良好（斯皮尔曼rho > 0.90）。血糖和细胞计数的措施从baseline.ConclusionsAnalysis胸水从胸管收集系统是可行的，可以提供有用的诊断信息。从业人员在解释获得的样本时应考虑每种测量的测试特性。
BackgroundPleural fluid is typically drawn directly from the pleural space for diagnostic studies, but occasionally analyses are desired when a chest tube is already in place and a traditional approach is not feasible. The diagnostic value of analyzing fluid samples obtained from the pleural fluid collection system after chest tube insertion is unknown.MethodsWe performed a prospective observational study of patients in whom chest tube placement was planned for clinical indications. Diagnostic studies were performed on fluid obtained from the pleural space at the time of tube insertion and then repeated 2, 6, and 24 h later on samples obtained from the fluid collection system.ResultsFifty-five percent of the 23 effusions studied met light’s criteria for exudate at baseline. Lactate dehydrogenase (LDH) varied considerably over time from baseline measures with only 25 % of measures at 24 h falling within 25 % of baseline levels. The sensitivity for exudate by LDH remained 100 % with poor specificity ranging 50–69 % with repeat measures. Total protein exhibited less variability with 85 % of measures at 24 h falling within 25 % of baseline measure. Sensitivity and specificity at 24 h were 88 and 82 %, respectively. Repeat measures of cholesterol, albumin, and triglycerides generally correlated well (Spearman’s rho > 0.90) with baseline values. Measures of glucose and cell counts varied considerably from baseline.ConclusionsAnalysis of pleural fluid from a chest tube collection system is feasible and can provide useful diagnostic information. Practitioners should consider the test characteristics of each measure when interpreting samples obtained.