Dear all,
Do you reject samples for pleural fluid pH that are blood stained?
There is lots of evidence and guidance published on rejecting samples that are not collected anaerobically and are delayed in arriving at the laboratory and obviously there is the issue of not all blood gas analysers being CE marked for pleural fluid.
We currently routinely reject those that are blood stained visually on the basis of the buffering effect of blood and one of our Respiratory Consultants has queried this but I can’t find anything published to back this up.
Obviously if the sample was so bloody that it would be likely to clot in the analyser I can see it being a problem. Also now I think more about it I wonder if the buffering idea is less important if there is a haemothorax rather than if the blood was “added” as part of a traumatic tap as presumably the limited data on the usefulness and cut-off for pleural pH in the context of para-pneumonic effusion was on samples that in reality may well have been blood stained.
Any thoughts and what is your laboratory practice regarding blood stained pleural fluid please?
Hilary Durrant,
Chemical Pathologist,
Abertawe Bro Morgannwg Health Board,
Swansea.
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