Evaluation of Pleural Fluid Lactate for Diagnosis and Management of Parapneumonic Pleural Effusion

Clin Lab. 2016 Sep 1;62(9):1683-1687. doi: 10.7754/Clin.Lab.2016.160125.

Abstract

Background: The aim was to measure the accuracy of pleural fluid lactate concentration for diagnosis of parapneumonic pleural effusion (PPE) and to discriminate between uncomplicated (UPPE) and complicated PPE (CPPE).

Methods: Pleural fluid lactate was measured in patients with pleural effusion. Patients were classified into two groups according to the etiology of pleural effusion: PPE and NOT PPE.

Results: We studied 173 patients. Thirty patients were PPE (10 UPPE and 20 CPPE) and 143 were NOT PPE. The AUC value was 0.831 (p < 0.0001) and the optimal cutoff value was 5.6 mmol/L exhibiting 70% sensitivity and 90.9% specificity for diagnosis of PPE. Also, pleural fluid lactate could be used to discriminate between UPPE and CPPE, the AUC value was 0.740 (p = 0.0089) and the optimal cutoff value was 10.2 mmol/L, exhibiting 45% sensitivity and 90% specificity.

Conclusions: Pleural fluid lactate has a high accuracy for diagnosis and management of PPE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Area Under Curve
  • Biomarkers / analysis
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Female
  • Humans
  • Infant
  • Lactic Acid / analysis*
  • Male
  • Middle Aged
  • Pleural Effusion / diagnosis*
  • Pleural Effusion / etiology
  • Pneumonia / complications
  • ROC Curve
  • Reference Values
  • Sensitivity and Specificity
  • Young Adult

Substances

  • Biomarkers
  • Lactic Acid