Rapid differentiation of pathogenesis in patients with pulmonary edema by protein measurement with refractometer

No study has focused on using refractometer to rapidly determine total protein ratio of edema fluid to blood concentration (TPe/TPb) and, to differentiate hydrostatic pulmonary edema (HPE) from adult respiratory distress syndrome (ARDS). The reliability of refractometer was evaluated by correlating...

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Bibliographic Details
Published inZhonghua yi xue za zhi (Taipei, Taiwan) Vol. 56; no. 5; p. 298
Main Authors Lien, T C, Wang, J H
Format Journal Article
LanguageEnglish
Published China (Republic : 1949- ) 01.11.1995
Subjects
Adolescent
Adult
Aged
Diagnosis, Differential
Extravascular Lung Water - chemistry
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Proteins - analysis
Pulmonary Edema - etiology
Pulmonary Edema - metabolism
Refractometry
Reproducibility of Results
Respiratory Distress Syndrome, Adult - complications
Respiratory Distress Syndrome, Adult - diagnosis
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Summary:No study has focused on using refractometer to rapidly determine total protein ratio of edema fluid to blood concentration (TPe/TPb) and, to differentiate hydrostatic pulmonary edema (HPE) from adult respiratory distress syndrome (ARDS). The reliability of refractometer was evaluated by correlating the protein concentration measured by refractometer with that by sequential multiple autoanalyzer (SMA) in 91 blood samples. In intensive care unit, thirteen patients with florid pulmonary edema were included. All had an unequivocal diagnosis of either HPE or ARDS. Edema fluid and blood were collected simultaneously for the measurement of protein concentration by refractometer. Protein concentration measured by refractometer correlated excellently with that by sequential multiple autoanalyzer (r = 0.991, p < 0.00001). In 7 patients with ARDS, the mean TPe/TPb was 0.75 +/- 0.13. In contrast, in 6 patients with HPE, the mean TPe/TPb was 0.36 +/- 0.14. The difference between groups was significant (p < 0.005). An inverse correlation between TPe/TPb and wedge pressure was also significant (r = -0.814, p < 0.001). Using refractometer to determine protein ratio of edema fluid to blood concentration can rapidly and effectively distinguish ARDS from HPE in patients with florid pulmonary edema. TPe/TPb correlates inversely with wedge pressure in these patients.
ISSN:0578-1337