SEROUS FLUID

 Pleural, pericardial, peritoneal are lined by 2 membranes referred as SEROUS membrane

 The 2 membranes are
o Parietal membrane lines the cavity wall
o Visceral membrane covers the organ within the cavity
 Serous fluid – the fluid that is between the 2 membranes. It provides lubrication to avoid friction between the 2
(e.g expansion and contraction of the lungs)
 Small amount of serous fluid is present due to the production and reabsorption in constant rate take place
FORMATION
o Formed as ultrafiltrates of plasma
o Hydrostatic pressure (mo sulod ang fluid sa 2 ka membrane) and colloidal pressure (oncotic pressure)
reabsorption if nay filtration sa plasma which mo trigger sha na mo increase
o The continuous exchange of SF maintains the normal volume of the fluid
o Effusion  disruption of the formation and reabsorption of the serous fluid
SPECIMEN COLLECTION AND HANDLING
o Needle aspiration
o Pleural (thoracentesis)
o Pericardial (pericardiocentesis)
o Peritoneal (paracentesis)
o >100mL if abundant fluid; usually collected
EDTA Cell and diff count
Heparin or sodium polyanethol Microbiology and cytology
sulfonate
Centrifugation Recovery of microorganism and
abnormal cells
No anticoagulant tube (red top) and Chemistry
heparin
o Specimen for pH must maintained anaerobically with ice
o Chemical test usually performed due to fluid is plasma ultrafiltrate and blood specimen should be obtain at
time of collection
TRANSUDATES AND EXUDATES
 Effusion is due to systemic disorder that disrupt the balance in regulation of the formation and reabsorption of
the fluid
 The hydrostatic pressure is CHANGE due to:
o Congestive heart failure or hypoproteinemia associated with nephrotic syndrome called TRANSUDATES
o Conditions that direct involvement to the membranes such as infection and malignancies called
EXUDATES
 Reliable determination is obtaining the: Evaluation: appearance and differentiation between a transudate and an
o Blood ratio for protein exudates
o Lactic dehydrogenase
GENERAL LABORATORY PROCEDURES  Effusions of exudative origin are then examined for the presence
of microbiologic and cytologic abnormalities.
 Red blood cell (RBC) and white blood cell (WBC) counts are not
routinely performed on serous fluids because they provide little
diagnostic information.
 In general, WBC counts greater than 1000/uL and RBC counts
greater than 100,000uL indicate an exudate
 Manual counts considered the NRBC, tissue cells and debris
 Automated care must taken to avoid the blocking of tubing with
debris
 Diff count preferably the Wright’s stain, cytocentrifuge, centrifuge
o Examine the normal and malignant tissue cells