Light's criteria and the SAAG...
We approach pleural effusions and ascites differently, but is there a deeper truth... a common theme that connects them?
Na.
Just wasted 10 seconds of your time.
JK. JK!
OF COURSE there is!
We approach pleural effusions and ascites differently, but is there a deeper truth... a common theme that connects them?
Na.
Just wasted 10 seconds of your time.
JK. JK!
OF COURSE there is!
There are 2 common ways that fluid seeps into a serosal surface like the pleura and peritoneum.
1. Venous hypertension -> transudate
2. Inflammation -> exudate
1. Venous hypertension -> transudate
2. Inflammation -> exudate
Let's focus on the venous hypertension.
That two exists in two forms:
1. Systemic venous HTN - CHF/renal disease
2. Local venous HTN - brachiocephalic occlusion [bit.ly] / portal HTN
That two exists in two forms:
1. Systemic venous HTN - CHF/renal disease
2. Local venous HTN - brachiocephalic occlusion [bit.ly] / portal HTN
So..
A transudative effusion?
Look for venous HTN - be it systemic or local.
A exudate?
Find the cause of the inflammation - infection > cancer > autoimmune > drug.
A transudative effusion?
Look for venous HTN - be it systemic or local.
A exudate?
Find the cause of the inflammation - infection > cancer > autoimmune > drug.
Is it really that simple?
Na...medicine = constant awe & humility.
This simple framework will take you far in most cases, but...
there are a few other things that can sneak in...
Na...medicine = constant awe & humility.
This simple framework will take you far in most cases, but...
there are a few other things that can sneak in...
Yup. Sneak in.
In the more common cases of venous HTN and inflammation - the fluid leaks out right THERE in the serosal surface [pleura or peritoneum].
Sometimes though, fluid formed somewhere ELSE seeps into a space it should be in and voila!...you have a effusion.
In the more common cases of venous HTN and inflammation - the fluid leaks out right THERE in the serosal surface [pleura or peritoneum].
Sometimes though, fluid formed somewhere ELSE seeps into a space it should be in and voila!...you have a effusion.
If it's fluid inherently low in protein [CSF], it's look like a transudate.
If it's stock full of protein [or LDH] it'll look like an exudate.
Want some practice?
Check out this @CPSolvers VMR case by the one and only @RezidentMD
bit.ly
If it's stock full of protein [or LDH] it'll look like an exudate.
Want some practice?
Check out this @CPSolvers VMR case by the one and only @RezidentMD
bit.ly
![If it's fluid inherently low in protein [CSF], it's look like a transudate.
If it's stock full of p...](https://pbs.twimg.com/media/Eb7Y0iFU4AEAs7f.jpg)
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