Use of Pleural Fluid N-Terminal-Pro-Brain Natriuretic Peptide and Brain Natriuretic Peptide in Diagnosing Pleural Effusion Due to Congestive Heart Failure

摘要

Pleural effusions have classically been divided intontransudates and exudates. Most transudativenpleural effusions are due to heart failure. The criterianof Light et aln1 have been used to make this differ-nentiation for the past 25 years. The main problemnwith those criteria is that although they identifynnearly all exudates correctly, they misidentify aboutn20 to 25% of transudates as exudates.n2 Almost all of the patients with misclassified transudates have heartnfailure and are receiving therapy with diuretics.nAlthough modifications to the criteria of Light et aln1nand alternative measures such as the pleural fluidncholesterol level have been assessed as alternativenmeasures to separate transudates from exudates,nnone are superior to the criteria of Light et al.n3