Anion Gap in Turpentine-Induced Pleural Effusions * Correlation with pH and Protein Level

William D. Paulson, Michelene Hearth-Holmes, Steven W. Stogner, G. Douglas Campbell, Katharine A. Kirk, Ronald B. George

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Since the pleural fluid proteins and lactate are unmeasured unions, the pleural fluid anion gap (Na+K-Cl-total CO2) should vary with the protein level and should be high in acidic effusions (which have high lactate levels). The anion gap is also convenient and inexpensive to measure, and less subject to artifact than the pH measurement. To test the hypothesis that the anion gap correlates with the pH, protein level, and other traditional pleural fluid measurements, we used a well-described model of turpentine-induced effusions in nine New Zealand white rabbits. Nonacidic exudative effusions were induced by an intrapleural injection of turpentine; acidic exudative effusions were induced by a second injection. Pleural fluid and blood were obtained just before (0 h) and 9, 24, 48, and 72 h after the second injection. We found the anion gap correlated with pH, the glucose, protein, and lactate dehydrogenase levels, pleural-fluid/plasma protein and lactate dehydrogenase ratios, and WBC count (all p<0.001). The pH and protein ratio together accounted for 95% of all anion gap variation within individual subjects. We also found the influence of the PCO2 level on pH was not significant after taking into account the influence of the anion gap. These results suggest the anion gap may be useful in the clinical evaluation of pleural effusions and could potentially replace the pH measurement.

Original languageEnglish (US)
Pages (from-to)504-509
Number of pages6
JournalCHEST
Volume109
Issue number2
DOIs
StatePublished - Jan 1 1996

Fingerprint

Turpentine
Acid-Base Equilibrium
Pleural Effusion
Proteins
L-Lactate Dehydrogenase
Injections
Lactic Acid
Glucose 1-Dehydrogenase
Artifacts
Blood Proteins
Rabbits

Keywords

  • Acid-base imbalance
  • Anion gap
  • Exudate
  • Lactic acidosis
  • Pleural effusion

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Paulson, W. D., Hearth-Holmes, M., Stogner, S. W., Campbell, G. D., Kirk, K. A., & George, R. B. (1996). Anion Gap in Turpentine-Induced Pleural Effusions * Correlation with pH and Protein Level. CHEST, 109(2), 504-509. https://doi.org/10.1378/chest.109.2.504

Anion Gap in Turpentine-Induced Pleural Effusions * Correlation with pH and Protein Level. / Paulson, William D.; Hearth-Holmes, Michelene; Stogner, Steven W.; Campbell, G. Douglas; Kirk, Katharine A.; George, Ronald B.

In: CHEST, Vol. 109, No. 2, 01.01.1996, p. 504-509.

Research output: Contribution to journalArticle

Paulson, WD, Hearth-Holmes, M, Stogner, SW, Campbell, GD, Kirk, KA & George, RB 1996, 'Anion Gap in Turpentine-Induced Pleural Effusions * Correlation with pH and Protein Level', CHEST, vol. 109, no. 2, pp. 504-509. https://doi.org/10.1378/chest.109.2.504
Paulson, William D. ; Hearth-Holmes, Michelene ; Stogner, Steven W. ; Campbell, G. Douglas ; Kirk, Katharine A. ; George, Ronald B. / Anion Gap in Turpentine-Induced Pleural Effusions * Correlation with pH and Protein Level. In: CHEST. 1996 ; Vol. 109, No. 2. pp. 504-509.
@article{91fc425c22c0483d90eaeaaa24f27d1e,
title = "Anion Gap in Turpentine-Induced Pleural Effusions * Correlation with pH and Protein Level",
abstract = "Since the pleural fluid proteins and lactate are unmeasured unions, the pleural fluid anion gap (Na+K-Cl-total CO2) should vary with the protein level and should be high in acidic effusions (which have high lactate levels). The anion gap is also convenient and inexpensive to measure, and less subject to artifact than the pH measurement. To test the hypothesis that the anion gap correlates with the pH, protein level, and other traditional pleural fluid measurements, we used a well-described model of turpentine-induced effusions in nine New Zealand white rabbits. Nonacidic exudative effusions were induced by an intrapleural injection of turpentine; acidic exudative effusions were induced by a second injection. Pleural fluid and blood were obtained just before (0 h) and 9, 24, 48, and 72 h after the second injection. We found the anion gap correlated with pH, the glucose, protein, and lactate dehydrogenase levels, pleural-fluid/plasma protein and lactate dehydrogenase ratios, and WBC count (all p<0.001). The pH and protein ratio together accounted for 95{\%} of all anion gap variation within individual subjects. We also found the influence of the PCO2 level on pH was not significant after taking into account the influence of the anion gap. These results suggest the anion gap may be useful in the clinical evaluation of pleural effusions and could potentially replace the pH measurement.",
keywords = "Acid-base imbalance, Anion gap, Exudate, Lactic acidosis, Pleural effusion",
author = "Paulson, {William D.} and Michelene Hearth-Holmes and Stogner, {Steven W.} and Campbell, {G. Douglas} and Kirk, {Katharine A.} and George, {Ronald B.}",
year = "1996",
month = "1",
day = "1",
doi = "10.1378/chest.109.2.504",
language = "English (US)",
volume = "109",
pages = "504--509",
journal = "Chest",
issn = "0012-3692",
publisher = "American College of Chest Physicians",
number = "2",

}

TY - JOUR

T1 - Anion Gap in Turpentine-Induced Pleural Effusions * Correlation with pH and Protein Level

AU - Paulson, William D.

AU - Hearth-Holmes, Michelene

AU - Stogner, Steven W.

AU - Campbell, G. Douglas

AU - Kirk, Katharine A.

AU - George, Ronald B.

PY - 1996/1/1

Y1 - 1996/1/1

N2 - Since the pleural fluid proteins and lactate are unmeasured unions, the pleural fluid anion gap (Na+K-Cl-total CO2) should vary with the protein level and should be high in acidic effusions (which have high lactate levels). The anion gap is also convenient and inexpensive to measure, and less subject to artifact than the pH measurement. To test the hypothesis that the anion gap correlates with the pH, protein level, and other traditional pleural fluid measurements, we used a well-described model of turpentine-induced effusions in nine New Zealand white rabbits. Nonacidic exudative effusions were induced by an intrapleural injection of turpentine; acidic exudative effusions were induced by a second injection. Pleural fluid and blood were obtained just before (0 h) and 9, 24, 48, and 72 h after the second injection. We found the anion gap correlated with pH, the glucose, protein, and lactate dehydrogenase levels, pleural-fluid/plasma protein and lactate dehydrogenase ratios, and WBC count (all p<0.001). The pH and protein ratio together accounted for 95% of all anion gap variation within individual subjects. We also found the influence of the PCO2 level on pH was not significant after taking into account the influence of the anion gap. These results suggest the anion gap may be useful in the clinical evaluation of pleural effusions and could potentially replace the pH measurement.

AB - Since the pleural fluid proteins and lactate are unmeasured unions, the pleural fluid anion gap (Na+K-Cl-total CO2) should vary with the protein level and should be high in acidic effusions (which have high lactate levels). The anion gap is also convenient and inexpensive to measure, and less subject to artifact than the pH measurement. To test the hypothesis that the anion gap correlates with the pH, protein level, and other traditional pleural fluid measurements, we used a well-described model of turpentine-induced effusions in nine New Zealand white rabbits. Nonacidic exudative effusions were induced by an intrapleural injection of turpentine; acidic exudative effusions were induced by a second injection. Pleural fluid and blood were obtained just before (0 h) and 9, 24, 48, and 72 h after the second injection. We found the anion gap correlated with pH, the glucose, protein, and lactate dehydrogenase levels, pleural-fluid/plasma protein and lactate dehydrogenase ratios, and WBC count (all p<0.001). The pH and protein ratio together accounted for 95% of all anion gap variation within individual subjects. We also found the influence of the PCO2 level on pH was not significant after taking into account the influence of the anion gap. These results suggest the anion gap may be useful in the clinical evaluation of pleural effusions and could potentially replace the pH measurement.

KW - Acid-base imbalance

KW - Anion gap

KW - Exudate

KW - Lactic acidosis

KW - Pleural effusion

UR - http://www.scopus.com/inward/record.url?scp=0030027007&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030027007&partnerID=8YFLogxK

U2 - 10.1378/chest.109.2.504

DO - 10.1378/chest.109.2.504

M3 - Article

C2 - 8620729

AN - SCOPUS:0030027007

VL - 109

SP - 504

EP - 509

JO - Chest

JF - Chest

SN - 0012-3692

IS - 2

ER -