Light’s Criteria Revisited: Consistency and Comparison with New Proposed Alternative Criteria for Separating Pleural Transudates from Exudates

@article{Romero2000LightsCR,
  title={Light’s Criteria Revisited: Consistency and Comparison with New Proposed Alternative Criteria for Separating Pleural Transudates from Exudates},
  author={Santiago Romero and Adela Ben{\'i}tez-Cano Mart{\'i}nez and Luis Hern{\'a}ndez and Cleof{\'e} Fern{\'a}ndez and Antoni Espasa and Alfredo Candela and Concepci{\'o}n Mart{\'i}n},
  journal={Respiration},
  year={2000},
  volume={67},
  pages={18 - 23}
}
Objectives: The first objective was to assess the diagnostic value of new biochemical criteria proposed to discriminate pleural transudates from exudates and to compare their efficiency with those of Light’s criteria. The second objective of the study was to assess the interstudy variability of the parameters repeatedly determinated in two different groups of patients with pleural effusion. Patients and Methods: We recorded clinical characteristics and final diagnoses and measured pleural fluid… Expand
Is it meaningful to use biochemical parameters to discriminate between transudative and exudative pleural effusions?
TLDR
Light's criteria are significantly superior to the clinical presumption to separate pleural transudates from exudates and in patients receiving diuretics, Light's criteria lose accuracy, which is similar to that showed by the use of alternative biochemical criteria alone or combined with clinical judgment. Expand
New criteria for the differentiation between transudates and exudates.
TLDR
Routine measurement of fluid LDH values and the calculation of fluid to serum total protein ratios will aid in differentiating exudates from transudates. Expand
Useful tests on pleural fluid that distinguish transudates from exudates
TLDR
The use of PF LD and cholesterol in combination as an alternative method for distinguishing pleural transudates from exudates is suggested, which avoids the need for venepuncture and the simultaneous collection of a blood sample. Expand
Combined pleural fluid cholesterol and total protein in differentiation of exudates and transudates.
TLDR
Pleural fluid cholesterol and total protein are simple, cost-effective, and useful parameters in distinguishing pleural transudates from exudates, with the advantage of requiring only two laboratory determinations and no simultaneous blood sample, compared to the use of Light's criteria. Expand
Classification tree analysis for the discrimination of pleural exudates and transudates
TLDR
CART-based algorithms can efficiently discriminate between pleural exudates and transudates, as well as select PF protein and PF LDH as the most discriminatory variables. Expand
Comparison of Heffner Criteria and Light Criteria in Differentiating Exudative and Transudative Pleural Effusion
TLDR
There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion, so a combination of criteria might be useful in case where there is difficulty to identify the cause. Expand
Pleural Interleukin-1β in Differentiating Transudates and Exudates: Comparative Analysis with Other Biochemical Parameters
TLDR
Although IL-1β could be a marker with relatively good sensitivity and PPV for the differentiation of pleural effusion, the cost and time needed do not support its use as a routine laboratory test. Expand
The separation of transudates and exudates with particular reference to the protein gradient
TLDR
It seems that looking for the causes of misclassification, when applying the criteria that to date have shown better efficiency, deserves preferential investigation, and the use of biochemical criteria seems mandatory. Expand
Improving the predictive accuracy of identifying exudative effusions.
TLDR
In cases where no cause for an exudative effusion can be identified or CHF is suspected, the sequential application of the fluid LDH, followed by theSF-P and then the SF-A gradients may assist in reclassifying pleural effusions as transudates. Expand
“Efficacy of Total Pleural Fluid Bilirubin And Ratio to Serum Levels, Pleural Fluid Cholesterol And Total Protein Level in Diagnosing Pleural Effusion Exudates And Transudates And Its Correlation with light’s Criteria”
TLDR
Though Light's criteria remains as gold standard to differentiate transudates and exudates, in cases where there is a mismatch between clinical diagnosis and the outcome from Light’s criteria, pleural fluid bilirubin / serum bilirUBin ratio and Pleural fluid total protein evaluation may add to the diagnostic accuracy. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 20 REFERENCES
Evaluation of different criteria for the separation of pleural transudates from exudates.
TLDR
The criteria of Light et al remain the method that offers the highest accuracy for segregating transudates from exudates when the proportion of exudate included is 85 percent or more. Expand
Comparative analysis of the biochemical parameters used to distinguish between pleural transudates and exudates.
TLDR
The criteria of Light et al remain the best method for distinguishing exudates from transudates and the serum-effusion albumin gradient is useful when patients are receiving concurrent diuretic therapy. Expand
Diagnostic value of tests that discriminate between exudative and transudative pleural effusions. Primary Study Investigators.
TLDR
It was found that all eight tests had similar diagnostic accuracies when evaluated by receiver operating characteristic (ROC) analysis except for BILI-R, which was less diagnostically accurate. Expand
Cholesterol: a useful parameter for distinguishing between pleural exudates and transudates.
TLDR
It is concluded that determination of PCHOL and P/SCHOL is of great value for distinguishing between pleural exudates and transudates, and should be included in routine laboratory analysis of pleural effusions. Expand
Measurement of pleural fluid cholesterol and lactate dehydrogenase. A simple and accurate set of indicators for separating exudates from transudates.
TLDR
The measurement of Pleural cholesterol and LDH permits the separation of pleural exudates from transudates with an accuracy similar to the original report of Light et al, with the advantage of requiring only two laboratory determinations and no simultaneous blood sample. Expand
Pleural fluid to serum cholinesterase ratio for the separation of transudates and exudates.
TLDR
The pleural fluid to serum cholinesterase ratio is the most accurate criterion for separating pleural transudates and exudates, and could be used as the first step in the diagnosis of pleural effusions. Expand
Diagnostic principles in pleural disease.
  • R. Light
  • Medicine
  • The European respiratory journal
  • 1997
TLDR
When a patient with an undiagnosed pleural effusion is evaluated, the first question to answer is whether the patient has a transudate or an exudate, and additional tests are indicated to determine the aetiology of the effusion. Expand
Cholesterol in pleural effusions. A diagnostic aid.
TLDR
Findings indicate that the pleural fluid cholesterol level is a simple and cost-effective aid in differentiating exudative from transudative pleural effusions. Expand
Evaluating pleural effusions. A two-stage laboratory approach.
TLDR
Light et al 2 have shown that in a select group of patients, transudates and exudates can be separated in the laboratory by measuring the protein and lactate dehydrogenase. Expand
Pleural effusions: the diagnostic separation of transudates and exudates.
TLDR
The utility of pleural-fluid cell counts, protein levels, and lactic dehydrogenase levels for the separation of transudates from e... Expand
...
1
2
...