SEROUS FLUID

SEROUS FLUID

Fluid secreted by serous membranes that reduces friction in the

serous cavities (pleural, pericardial, and peritoneal).

Any of various body fluids resembling serum, especially lymph.

A fluid that has the characteristics of serum.

A fluid that has the characteristics of serum in color and viscosity.

3 P’s

Pleural

Peritoneal

Pericardial

Normal

Clear and Pale Yellow

PLEURAL FLUID: Specimen Collection

Thoracentesis

Chylous Effusion

Increase TAG

(+) Pos: Sudan

Presence of cholesterol crystals

Pseudochylous Effusion

Decrease TAG

(-) Neg: Sudan

Absence of cholesterol crystals

PERICARDIAL

Specimen Collection: Pericardiocentesis

Volume: 10-50ml.

PERITONEAL CAVITY

Specimen Collection: Paracentesis

ASCITES- Accumulation of fluid in peritoneal cavity

Serum-Ascites Albumin Gradient

>/= to 1.1 –Transudates

< 1.1 – Exudates

Transudate

Abnormally accumulated due to systemic disorder that disrupts the balance in the regulation of fluid filtration absorption

Exudate

Abnormally accumulated products of fluid in cells due to bacterial invasion, parasites, sterile-irritating agents

Associates with malignancies

Transudate

Non-inflammatory origin

Transudate

No crystals

Transudate

Clear & colorless

Transudate

Odorless

Transudate

No coagulation

Exudate

Inflammatory origin

Exudate

May contains crystals

Exudate

Cloudy, turbid/orange-red

Exudate

Fecaloid, sweet or foul

Exudate

Coagulates

Vacutainer Tube to be Used:

ANTICOAGULATED TUBE (EDTA): CELL COUNT

STERILE TUBE: CULTURE

HEPARINIZED TUBE: CHEMISTRY

NON-ANTICOAGULATED: CLOTTING

FLUID SHOULD BE RETAINED

7-10 DAYS IN CASE OF FURTHER TESTING

Transudate

Alkaline pH

Exudate

Acidic pH

Transudate

Leukocyte count:

<1000 cells/μL (plueral)

<300 cells/μL (peritoneal)

Differential count:

Mononuclear cells (predominant)

Exudate

Leukocyte count:

>1000 cells/μL (plueral)

>500 cells/μL (peritoneal)

Differential count:

Neutrophils (early infection)

Mononuclear cells (late infection)

Albumin Test

Albumin/Protein

Rivalta’s Test

Presence of fibrinogen

Biuret’s Test

Protein determination

Benedict’s Test

Qualitative test for glucose

Cytologic Test

Cell count & malignancy

Bacteriologic Exam

Gram stain, ziehl-neelsen, culture