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Pleural fluid analysis
Pleural fluid analysis is a test that examines a sample of fluid that has collected in the pleural space. This is the space between the lining of the outside of the lungs (pleura) and the wall of the chest. When fluid collects in the pleural space, the condition is called pleural effusion .
Pleural effusion
A pleural effusion is a buildup of fluid between the layers of tissue that line the lungs and chest cavity.
How the Test is Performed
A procedure called thoracentesis is used to get a sample of pleural fluid. The health care provider examines the sample to look for:
Thoracentesis
Thoracentesis is a procedure to remove fluid from the space between the lining of the outside of the lungs (pleura) and the wall of the chest....
- Cancerous (malignant) cells
- Other types of cells (for example blood cells)
- Levels of glucose, protein and other chemicals
- Bacteria, fungi, viruses, and other germs that can cause infections
- Inflammation
How to Prepare for the Test
No special preparation is needed before the test. A chest x-ray will be performed before and after the test.
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
DO NOT cough, breathe deeply, or move during the test to avoid injury to the lung.
Tell your provider if you take medicines to thin the blood.
How the Test will Feel
For thoracentesis, you sit on the edge of a chair or bed with your head and arms resting on a table. The provider cleans the skin around the insertion site. Numbing medicine (anesthetic) is injected into the skin.
A needle is placed through the skin and muscles of the chest wall into the pleural space. As fluid drains into a collection bottle, you may cough a bit. This is because your lung re-expands to fill the space where fluid had been. This sensation lasts for a few hours after the test.
During the test, tell your provider if you have sharp chest pain or shortness of breath.
The provider may use ultrasound to get a better view of the fluid in your chest.
Why the Test is Performed
The test is performed to determine the cause of a pleural effusion. It is also done to relieve the shortness of breath that a large pleural effusion can cause.
Normal Results
Normally the pleural cavity contains less than 20 milliliters (4 teaspoons) of clear, yellowish (serous) fluid.
What Abnormal Results Mean
Abnormal results may indicate possible causes of pleural effusion, such as:
- Cancer
-
Cirrhosis
Cirrhosis
Cirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease.
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Heart failure
Heart failure
Heart failure is a condition in which the heart is no longer able to pump oxygen-rich blood to the rest of the body efficiently. This causes symptom...
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-
Severe
malnutrition
Malnutrition
Malnutrition is the condition that occurs when your body does not get enough nutrients.
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- Abnormal connections between the pleural space and other organs (for example, the esophagus)
If the provider suspects an infection, a culture of the fluid is done to check for bacteria.
Culture of the fluid
Pleural fluid culture is a test that examines a sample of fluid that has collected in the pleural space to see if you have an infection or understand...
The test may also be performed for hemothorax . This is a collection of blood in the pleura.
Hemothorax
Hemothorax is a collection of blood in the space between the chest wall and the lung (the pleural cavity).
Risks
Risks of thoracentesis are:
-
Collapsed lung (
pneumothorax
)
Pneumothorax
A collapsed lung occurs when air escapes from the lung. The air then fills the space outside of the lung, between the lung and chest wall. This bui...
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- Fluid re-accumulation
- Infection
-
Pulmonary edema
Pulmonary edema
Pulmonary edema is an abnormal buildup of fluid in the lungs. This buildup of fluid leads to shortness of breath.
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Respiratory distress
Respiratory distress
Acute respiratory distress syndrome (ARDS) is a life-threatening lung condition that prevents enough oxygen from getting to the lungs and into the bl...
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Serious complications are uncommon.
References
Broaddus VC, Light RW. Pleural effusion. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.
Kosowsky JM, Kimberly HH. Pleural disease. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 77.
Review Date: 11/19/2015
Reviewed By: Denis Hadjiliadis, MD, MHS, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
