A Comparative Study to Evaluate the Diagnostic Accuracy of Bedside Hydrogen Peroxide Test and Light’s Criteria in Differentiating Pleural Effusions as Transudate and Exudate
Background Pleural effusions are common manifestations of a variety of pathologies. The specific cause must be identified to initiate timely treatment. The primary step in establishing a diagnosis is to diff...
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| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Rajiv Gandhi University of Health Sciences
2025-01-01
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| Series: | RGUHS Journal of Medical Sciences |
| Online Access: |
https://journalgrid.com/view/article/rjms/12434452 |
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| Summary: | Background Pleural effusions are common manifestations of
a variety of pathologies. The specific cause must be identified to initiate
timely treatment. The primary step in establishing a diagnosis is to
differentiate transudative and exudative effusions for which Lightrsquos
criteria have been accepted as the gold standard. However recent studies
investigating Lightrsquos criteria have revealed high sensitivity for
exudates but low specificity. This prompted us to evaluate bedside hydrogen
peroxide H2 O2 test as an alternative to Lightrsquos criteria.Methods A
cross-sectional study involving 100 subjects was conducted to determine the
diagnostic accuracy of the bedside H2nbspO2nbsptest in differentiating
transudative and exudative pleural fluids using the Lightrsquos criteria as
the reference standard. According to Lightrsquos criteria a pleural effusion
is classified as an exudate when the pleural fluid proteinserum protein
ratio gt0.5 or the pleural fluid lactate dehydrogenase LDHserum LDH gt0.6. A
transudate is diagnosed when these criteria are not met. In the
H2nbspO2nbsptest an exudate is identified by the appearance of profuse
bubbling within one minute of adding H2nbspO2nbspto the pleural fluid
whereas the absence of bubbling indicates a transudate.nbspResults A male
preponderance was observed with a higher incidence of pleural effusion among
urban dwellers. Among the study population 74 were chronic tobacco consumers
and 62 were chronic alcoholics. The H2nbspO2nbsptest demonstrated a
sensitivity of 88.52 specificity of 94.87 positive predictive value of 96.4
negative predictive value of 88.4 and an overall diagnostic accuracy of
91.0.Conclusion The simple bedside H2nbspO2nbsptest facilitates rapid
categorization of pleural fluid as transudate or exudate thereby reducing
diagnostic turn around time and allowing for earlier initiation of
treatment. Additionally the H2 O2 test is cost-effective making it more
viable option in resource-deficient laboratory settings. nbsp |
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| ISSN: | 2231-1947 2581-7248 |