Last week we talked about how to determine if your effusion was septic. This week, let’s have a look into further evaluation of effusion samples.
If the effusion is haemorrhagic, here are some things to look out for.
Real or iatrogenic origin:
- Blood rapidly defibrinates in cavities so if it clots then it is iatrogenic
- If it swirls during collection it is more likely to be iatrogenic
Is it acute or chronic?
- Compare PCV/TP to peripheral, if sample PCV/TP = peripheral blood PCV/TP then a recent bleed is most likely the cause
- Always run a PCV/TP on haemorrhagic effusions don’t always assume it is from a large haemorrhage. Effusions with low PCVs e.g. 5 can look like frank blood!
- If sample PCV is low but TP is the same as peripheral blood then the bleed is likely chronic
- If erythrophagocytosis is present then it is chronic, look for macrophages, which contain dark brown to green pigments in your smear
- Also assess for the presence of clumped platelets, this can mean intravascular sampling or a very acute bleed
These tips should help with evaluating your effusion samples more effectively.