English 
Italian CONTRIBUTI SCIENTIFICI – Scientific Papers
Volume:
Biochimica Clinica 2018; 42(2) 119-130
Pubblicato on-line:
April 5, 2018
DOI:
10.19186/BC_2018.022
Indagine conoscitiva congiunta SIBioC-Medicina di Laboratorio e Associazione Italiana Pneumologi Ospedalieri (AIPO) relativa alla gestione del processo diagnostico del liquido pleurico
AUTORI
1Unità Operativa Complessa SMeL2 Analisi Chimico Cliniche, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo
2Centro Regionale di Riferimento, Struttura Organizzata Dipartimentale Sicurezza e Qualità, Azienda Ospedaliera Universitaria Careggi, Firenze
3Divisione di Pneumologia, Azienda Sanitaria Locale 5, La Spezia
4Università Politecnica delle Marche, Ancona
5Laboratorio di Patologia Clinica e Genetica Medica, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano
6Sezione di Biochimica Clinica e Medicina Molecolare Clinica, Dipartimento di Biopatologia e Biotecnologie Mediche, Unità Operativa Complessa e Dipartimento di Medicina di Laboratorio, Università degli Studi di Palermo
7Laboratorio di Chimica Clinica ed Ematologia, Ospedale Universitario di Verona
ABSTRACT
Results of a survey produced by the Italian Society of Clinical Biochemestry (SIBioC) and the Italian Association of Hospital Pneumologists (AIPO) concerning pleural fluid analysis
The aim of this paper is to present the preliminary results of a joint project by SIBioC-AIPO working group on “Body cavities fluids”. The main purpose of the working group is to achieve a harmonized and shared diagnostic pathway related to pleural fluid (PF) analysis. The multistep project begins with a state of the art analysis. A survey, sent to both laboratory medicine personnel and pneumologists, was conducted between October and December 2016. The questionnaire (21 questions) was made available through the web-based SurveyMonkey platform. Overall, 408 replies were collected, 40.4% from laboratory medicine specialists, 3.2% from laboratory technicians, 49.3% from pneumologists and 7.1% from professionals with non-specified qualification. Regarding the pre-analytical phase, the most critical issue resulted to be the clinical query, due to the lack of structured communication between clinicians and laboratory personnel. While over 76% of laboratory professionals stated that the working diagnosis was unavailable, 87% of pneumologists affirmed that the clinical question had been forwarded to the laboratory. An important issue was the widespread use of inappropriate containers for PF collection (60% of inappropriate tubes). Regarding the panel of tests, a satisfactory agreement was reached on the need to perform macroscopic analysis and cytometric evaluation, along with the assessment of pH, glucose, total proteins, lactate dehydrogenase and the respective ratios between PF and serum concentrations. As expected, the availability of verified or validated analytical methods, notably pH analysis, has emerged as a critical point. The layout of the laboratory report also needs improvements and better harmonization. Despite the many critical issues emerged from this survey, a positive feedback was reflected by a notable general interest on PF analysis, leading thus the way to produce a joint consensus document involving clinicians and laboratory personnel, as suggested by more than 30% of responders.