DIAGNOSTIC ACCURACY OF A DROP HYDROGEN PEROXIDE TO DIFFERENTIATE BETWEEN EXUDATIVE AND TRANSUDATIVE PLEURAL EFFUSION

Background: Patients  presenting with clinical and radiological features  suggestive of pleural  effusion will have to be managed by diagnostic and therapeutic aspirations . Underlying pleural effusion is either exudative or transudative which is determined by light’s criteria. Our study is meant to see the effectiveness of simple and rapid bed side diagnostic test that is H2O2 test in the place of light’s criteria.

AIMS: Bed side Hydrogen peroxide test to differentiate exudative and transdudative  pleural effusion.

Objectives: 1) To differentiate between exudate and trasudate pleural effusion through this simple bed side H2O2 test.

2) To compare the hydrogen peroxide test of pleural fluid to that of standard analysis as per light’s criteria.

Materials &Methods: This is a prospective observational study carried out in a tertiary care hospital from December 2023-April 2024.A total of 96 patients presenting with clinical and radiological features of pleural effusion who met the eligibility criteria are included in the study were subjected to routine diagnostic workup ,chest imaging, pleural fluid analysis and rapid H2O2 test of pleural fluid.

Result: There were 96 patients who had pleural effusion,of them  32 patients had nil or minimal reaction indicating transudative  pleural effusion while 64 patients had bubbling reaction indicating of exudative pleural effusion based on drop hydrogen peroxide test.  Pleural fluid analysis based on light’s criteria showed 21 patients as  transudative pleural effusion while 75 patients had exudative pleural effusion based on Light’s criteria .Sensitivity of A drop Hydrogen peroxide test was 81.3%, Specificity was 85.74%, Positive Predictive Value(PPV) was 95.3%.Negative Predictive Value (NPV) was 56.25% .  The diagnostic accuracy of A Drop hydrogen peroxide test in our study is 82.29% to differentiate the nature of pleural fluid into exudative and transudative.

Conclusion: This bedside test allows for more rapid determination of the nature of pleural effusions as an exudate or transudate  and can be used as a screening test while waiting for results through light’s criteria.Further reaserch have to be done to know the validity of this bed side test.