BODY FLUID ANALYSIS FOR CELULAR COMPOSITION细胞的构成体流体分析.pptVIP

Serousal Fluids Peritoneal Fluid Serousal Fluids Peritoneal Fluid 10-15 ml fluid normally present in pericardial space Causes of pericardial effusion: 1)infection 2)neoplasm 3)MI 4)hemorrhage 5)methabolic 6)RA HIV infected patients commonly have asymptomatic pericardial effusion In HIV associated cardiac temponade 45% are idiopathic, Tb and bacterial infections each accounts for 20% of cases Large effusions (350 ml) most often caused by malignancy or uremia Blood-like fluid represent hemorrhagic effusion or aspiration of blood from the heart Hct comparable to peripheral and blood gas analysis help to differentiate Serousal Fluids Pericardial Fluid Postpericardiotomy syndrome common but nonspecific complication of cardiac surgery, days to weeks following the injury Exudative pericardial effusion developed in over 80% of cases Presence of antimyocardial Abs suggests an immune mediated process Hct and RBC count have limited value in differential diagnosis of pericardial effusions. Total WBC 10,000/ul suggests bacterial, Tb or malignant pericarditis Metastatic Ca of lung and breast are most frequent cause of malignant pericardial effusion Serousal Fluids Pericardial Fluid Serousal Fluids The closed cavities of body are lined by serosal membranes (pleura – pericardium and pertoneum) The fluid is a plasma filtrate from capillaries of the parietal membrane The fluid is reabsorbed through the lymphatics and venules of the visceral membrane The small amounts of fluid facilitates movement of two membranes The serosal fluids are plasma ultra filtration and mesothelial lining does not add any substance For laboratory assessment needle aspiration is done (Thoracocentesis – Pericardiocentesis – Paracentesis) Serousal Fluids Evaluation of serous fluids directed first toward differentiating transudate from exudate Transudative effusions (usually bilateral in pleura) have mechanical process owning to systemic conditions, leading to increase capillary hydrostatic pr