How do you interpret ascitic fluid?

A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate. A low SAAG (<1.1g/dL) suggests the ascitic fluid is an exudate.

What is LDH fluid?

This test measures the level of lactate dehydrogenase (LDH), also known as lactic acid dehydrogenase, in your blood or sometimes in other body fluids. LDH is a type of protein, known as an enzyme. LDH plays an important role in making your body’s energy.

What blood test indicates ascites?

Though diagnostic paracentesis is the standard first step for evaluating new-onset ascites, serum brain natriuretic peptide (BNP) of greater than 364 pg/mL has been demonstrated to diagnose heart failure–related ascites with 99.1% accuracy. Serum BNP may be useful if ascites results are inconclusive for diagnosis.

How do you count cells in ascitic fluid?

At present, PMN cell count is routinely performed by a traditional hematological method with a light microscope in a manual counting chamber. For this method, 10 mL of ascitic fluid are collected in tubes containing ethylenediaminetetraacetic acid (EDTA) and centrifuged at 1500 r/min for 10 min.

What is the normal color of ascites fluid?

Ascitic fluid is typically translucent and yellow. Fluid of other colour or consistency may reflect specific underlying disease processes (see table).

What color should abdominal fluid be?

Normal peritoneal fluid has a clear, colorless to light yellow appearance. When a strangulating lesion is present, there is movement of protein followed by red blood cells and finally leukocytes into the peritoneal cavity. This results in the peritoneal fluid becoming turbid and red to brown.

What is LDH test?

The lactate dehydrogenase (LDH) test looks for signs of damage to the body’s tissues. LDH is an enzyme found in almost every cell of your body, including your blood, muscles, brain, kidneys, and pancreas. The enzyme turns sugar into energy. The LDH test measures the amount of LDH in your blood or other body fluid.

What is the color of ascites fluid?

What is the normal white cell count in peritoneal fluid?

Cell count: Normal ascitic fluid contains fewer than 500 leukocytes/µL and fewer than 250 polymorphonuclear leukocytes (PMNs)/µL. Any inflammatory condition can cause an elevated white blood cell count. A PMN count of greater than 250 cells/µL is highly suggestive of bacterial peritonitis.

How do you calculate ascites PMN?

The PMN count is calculated by multiplying the white cells/mm3 by the percentage of neutrophils in the differential. In a bloody sample, which contains a high concentration of red blood cells, the PMN count must be corrected: 1 PMN is subtracted from the absolute PMN count for every 250 red cells/mm3 in the sample.

What does the LDH of ascitic fluid indicate?

Ascitic Fluid LDH >400 Presence of any 2 of these three findings is usually associated with TB, Malignancy or Pancreatitis Absence of all three usually indicates hepatic cause The Serum-Ascites Albumin Gradient (SAAG)

What is the LDH level of pleural fluid?

1. Pleural fluid-to-serum protein ratio above 0.5 2. Pleural fluid LDH above two-thirds the upper limit of normal serum LDH 3. Pleural fluid-to-serum LDH ratio above 0.6 The routine analysis of LDH to differentiate exudative and transudative pericardial effusions is not considered helpful.

How to determine if ascites is due to portal hypertension?

Ascitic Fluid Analysis 1 Signs and symptoms of ascites. 2 Appearance of ascitic fluid. 3 Ascitic fluid biochemistry. 4 Ascitic fluid microscopy. 5 Serum Ascitic Albumin Gradient (SAAG) The Serum Ascitic Albumin Gradient (SAAG) indirectly measures portal pressure and can be used to determine if ascites is due to portal hypertension.

What does a high SAAG mean for ascitic fluid?

A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate. A low SAAG (<1.1g/dL) suggests the ascitic fluid is an exudate. Another way of differentiating between an exudate and a transudate is to assess the ascitic fluid’s lactate dehydrogenase (LDH) level: