Perception versus reality: the measuring of pleural fluid pH in the United States.
BACKGROUND
Pleural fluid pH measured by a blood gas analyzer is the only recommended method of pH measurement to guide management for patients with parapneumonic pleural effusions. Not all hospitals use blood gas analyzers for pleural fluid pH determination and it is unknown if physicians are aware of this problem.


OBJECTIVE
To determine if a discrepancy exists between the modality used for measuring pleural fluid pH and how physicians believe it is measured.


METHODS
We surveyed pulmonologists randomly across the USA by e-mail inquiring how they thought pleural fluid pH was measured at their laboratory. We then independently contacted the laboratory and asked how pleural fluid pH was actually measured.


RESULTS
Two hundred and sixty-seven pulmonologists completed the survey. Eighty-six percent of the pulmonologists use pleural fluid pH to manage complicated parapneumonic effusions. Forty-three percent did not recognize blood gas analyzer solely as the most accurate and validated method. Thirty-nine percent of the physicians who use pleural pH to manage effusions and believe that blood gas analyzers are the most accurate were wrong in their assumption that their laboratory was using this tool for pleural pH measurement.


CONCLUSIONS
Whether it is due to inaccurate knowledge or a perception of how pleural fluid pH is tested, a significant number of pulmonologists, when treating complicated parapneumonic effusions, may be making management decisions based on erroneous information.
Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine, University of East Carolina, Greenville, N.C. 27834, USA. bowlingm @ ecu.edu
Mark
M
Bowling
Peter
P
Lenz
Arjun
A
Chatterjee
John F
JF
Conforti
Edward F
EF
Haponik
Robert
R
Chin
D001291:Attitude of Health Personnel; D001784:Blood Gas Analysis / Q000295:instrumentation*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007755:Laboratories, Hospital; D008297:Male; D010465:Perception; D010996:Pleural Effusion / Q000378:metabolism*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D011237:Predictive Value of Tests; D015272:Pulmonary Medicine / Q000592:standards / Q000639:trends; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D014481:United States