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Transudates are caused by disturbances of hydrostatic or colloid osmotic pressure, not by inflammation. They have a low protein content in comparison to exudates and thus appear clearer. [6] Levels of lactate dehydrogenase (LDH) [7] or a Rivalta test can be used to distinguish transudate from exudate. [citation needed]
An accurate diagnosis of the cause of the effusion, transudate versus exudate, relies on a comparison of the chemistries in the pleural fluid to those in the blood, using Light's criteria. According to Light's criteria (Light, et al. 1972), a pleural effusion is likely exudative if at least one of the following exists: [31]
The usual criterion (included in Light's criteria) is that a ratio of pleural LDH to serum LDH greater than 0.6 [33] or 2 ⁄ 3 the upper limit of the normal laboratory value for serum LDH [34] indicates an exudate, while a ratio of less indicates a transudate.
An exudate is defined as pleural fluid to serum total protein ratio of more than 0.5, pleural fluid to serum LDH ratio > 0.6, and absolute pleural fluid LDH > 200 IU or > 2 ⁄ 3 of the normal. An exudate is defined as pleural fluid that filters from the circulatory system into lesions or areas of inflammation.
Transudate vs. exudate. Transudate: Exudate: Main causes ↑ hydrostatic pressure, ↓ colloid osmotic pressure: ... fluid LDH upper limit for serum
The serum-ascites albumin gradient or gap (SAAG) is a calculation used in medicine to help determine the cause of ascites. [1] The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate.
For example, the specific gravity of the transudate is usually less than 1.012 and a protein content of less than 2 g/100 mL (2 g%). Rivalta test may be used to differentiate an exudate from a transudate. It is not clear if there is a distinction in the difference of transudates and exudates in plants.
The serum-ascites albumin gradient (SAAG) is probably a better discriminant than older measures (transudate versus exudate) for the causes of ascites. [12] A high gradient (> 1.1 g/dL) indicates the ascites is due to portal hypertension. A low gradient (< 1.1 g/dL) indicates ascites of non-portal hypertensive as a cause. [13]