Transudates and Exudates

The protein concentration of pleural fluid or abdominal ascites is occasionally measured to determine whether the sample is a transudate (fluid with a low protein content derived by filtration across the capillary endothelium) or an exudate (protein with a high protein content actively secreted in response to inflammation). Exudative pleural fluids generally have total protein concentrations approximately 30 g/L or a pleural fluid to plasma protein ratio of 0.5 however, the protein content of these 

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As early as 1964 and in later publications, it was possible to demonstrate the significance of glycoproteins (hexosamine, fucose, sialic acid [34], etc.) and cholinesterase for the detection of non-inflammatory, inflammatory or malignant disease and their follow-up as well as for the distinction between transudate and exudate in a so-called phlogogram (E. Kuntz, 1964). (see footnote p.298) Because of the significance and pathophysiological features of the mucopolysaccharides, appropriate biochemical parameters are likely to be of further interest. In addition, elevated values of hyaluronic acid have been found in the ascitic fluid of cirrhotic patients. 

Rector, W.G., Reynolds, T.B. Superiority of the serum-ascites albumin difference over the ascites total protein concentration in separation of transudative and exudative ascites. Amer. X Med. 1984 77 83-85... 

Light Light RW, Macgregor MI, Luchsinger PC, Ball WC Jr. Pleural effusions the diagnostic separation of transudates and exudates. Ann Intern Med 1972 77 507-13. 

Light, R. W., M. I. Macgregor, P. C. Luchisinger, and W. C. Ball. 1972. Pleural effusions The diagnostic separation of transudates and exudates. Annals of Internal Medicine 77 507-513. 

In cases of obstructive jaundice, bilirubin enters the lymphatic vessels, so that the lymphatic fluid is already icteric when it enters the thoracic duct. Exudates and transudates are always yellow-coloured in a certain correlation to the serum bilirubin values, although they contain less bilirubin (in accordance with their lower protein content) than the serum itself. Due to their larger protein content, exudates are more icteric in colour than transudates. Icteric colouring is hardly or not at all evident on paralyzed parts of the body. It would appear that bilirubin concentration also depends on normal nerve function. As a rule, jaundice is not detected in the region of an oedema (J. Meakins, 1927 J.H. Page, 1929). 

Heffner, J. E., L. K. Brown, and C. A. Barbieri. 1997. Diagnostic value of tests that discriminate between exudative and transudative pleural effusions. Chest 111 970-980. 

Aliabadi ES, Lees P, Pharmacokinetics and pharmacoki-netic/pharmacodynamic integration of marbofloxacin in calf serum, exudate and transudate, J. Vet. Pharmacol. Ther. 2002 25 161-174. 

The first protein wave ever observed was, as has been mentioned before, the presodium wave. It was found in polarographic examinations of serum, urine, bile, exudates, and transudates, where it preceded the wave caused by the elimination of sodium (8). This wave becomes defined in solutions of NH4CI (9), or in weakly alkaline buffer solutions. The wave is dependent on the protein concentration, and concentrations as low as 0.001% can be recorded. 

Polarographical examinations were performed, apart from the biological fluids already discussed separately, also of lymph, transudates, exudates, blister fluids, aqueous humor, tears, saliva, gastric and duodenal juices, sperm, uterine cervical secret, sweat, and tissues. 

Other cases of pleural and pericardial effusions have been reported in patients taking minoxidil, which have been thought to result from its vasodilatory action, leading to salt and water retention. In this case, as the effusion was exudative rather than transudative, the authors argued that another mechanism, such as a hypersensitivity reaction, was likely to have been responsible. 

Fig. 6 A 0.5 -inch-long grooved cobalt mandrel is inserted into tubing, which is sealed on both ends with medical adhesive. The grooves are intended to simulate the spaces between pacemaker lead conductor coils. A 1-mm-diameter hole is made in one end to assure ingress of exudate/transudate. Samples are tied together in strings, identified with a colored glass bead, and implanted in the subcutis of rabbits as shown in Fig. 3. After optical microscopic examination, the samples may be analyzed by FTIR, HPLC molecular weight, SEM, and other suitable techniques...

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