AMHSR

Diagnostic Accuracy of a Drop Hydrogen Peroxide Test to Differentiate Between Exudative and Transudative Pleural Effusion

Author(s): Bharati Taksande*, Anu Yarky, Trupti Patil and Vishakha Jain

Background: The differentiation of pleural effusions as being either transudate or exudate is the first step in the diagnostic workup of the biofluid. It has been shown that physicians are not very accurate to differentiate exudate from transudate. Routinely we use Light’s criteria to differentiate between exudate and transudate pleural fluid, however, it takes about 24 hours to get the results, hence we want to use the bedside test which gives us the result within 1 minute of thoracocentesis. The aim of our study is to determine the Diagnostic accuracy of Bedside test - A drop Hydrogen peroxide test to differentiate between exudative and transudative pleural fluid in comparison with Light’s criteria. Methods: We screened 1024 patients in outpatient department and included 172 patients in the study who had clinical and radiological evidence of pleural effusion. These patients underwent aseptic thoracocentesis. A drop of 30% hydrogen peroxide was added to 2 ml of pleural fluid which was tapped bedside and we looked for presence of bubbles. Rest of the pleural fluid was simultaneously sent for Light’s criteria analysis to laboratory and the results were then compared. Result: There were 172 patients who had pleural effusion, 150 (87.21%) of them had exudative pleural effusion and 22 (12.79%) had transudative pleural effusion by Light’s criteria and 125 (72.67%) of them had exudative pleural effusion and 47 (27.33%) had transudative pleural effusion by A drop hydrogen peroxide test. 121 were the true Positives and 18 were true negatives. 4 samples were false positive and 29 samples were false negative. Sensitivity of A drop Hydrogen peroxide test was 80.7%, Specificity was 81.8%, PPV was 96.8%, and NPV was 38.3% and Diagnostic Accuracy was 80.8%. Conclusion: This Bedside Test allows for more rapid determination of the nature of pleural effusions and can be rapidly characterized as an exudate or transudate.


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