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Clinical Investigations: TECHNIQUES |

Measuring Pleural Fluid pH*: High Correlation of a Handheld Unit to a Traditional Tabletop Blood Gas Analyzer

Gary L. Kohn, MD; William D. Hardie, MD
Author and Funding Information

*From the Division of Pulmonary Medicine, Children’s Hospital Medical Center, Cincinnati, OH.

Correspondence to: William D. Hardie, MD, Children’s Hospital Medical Center, Division of Pulmonary Medicine, OSB-5, 3333 Burnet Ave, Cincinnati, OH 45229; e-mail: bill.hardie@chmcc.org



Chest. 2000;118(6):1626-1629. doi:10.1378/chest.118.6.1626
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Study purposes: To survey hospital laboratories in the United States to determine methods used for measuring pleural fluid pH, and to compare pleural fluid pH values obtained with a traditional tabletop blood gas analyzer (BGA) to those obtained with a handheld analyzer.

Methods: Hospital laboratories nationwide were contacted by telephone to survey the methods used to measure pleural fluid pH. In a second phase, pleural fluid was prospectively collected from 19 pediatric and adult patients with pleural effusions, and pleural fluid pH was measured simultaneously with a traditional tabletop BGA and with a handheld unit.

Results: A total of 220 hospital laboratories were contacted by telephone, and 166 responded (75%). The methods for determining pleural fluid pH for all hospital laboratories were pH meter (35%; n = 59), BGA (32%; n = 53), and litmus paper (31%: n = 51); 2% (n = 3) did not perform the test. University hospitals were more likely to use a BGA, compared to community hospitals (p < 0.014) or children’s hospitals (p < 0.001). In the comparison of pleural fluid measurements, the mean pH for the traditional BGA was 7.358 ± 0.189, and the mean pH for the handheld unit was 7.382 ± 0.203. The absolute difference between the two machines was 0.024 U, and the two methods were correlated (p < 0.01; r = 0.993; degrees of freedom = 36).

Conclusion: Most hospital laboratories in the United States do not measure pleural fluid pH using a traditional BGA and use alternative methods that have previously been shown to be inaccurate. Pleural fluid pH obtained by a handheld unit has a high degree of correlation to that of a traditional tabletop BGA, and it offers a satisfactory alternative for laboratories reluctant to measure pleural fluid pH with a BGA.

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