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Light's Criteria

Differentiate exudative from transudative pleural effusions. Applied to pleural fluid obtained by thoracentesis.

Indication

  • Differentiate exudative from transudative pleural effusions. Applied to pleural fluid obtained by thoracentesis.

Criteria

  • id: fluid_protein; label: Pleural fluid protein (g/dL); type: number; placeholder: e.g. 4.0
  • id: serum_protein; label: Serum protein (g/dL); type: number; placeholder: e.g. 7.0
  • id: fluid_ldh; label: Pleural fluid LDH (U/L); type: number; placeholder: e.g. 250
  • id: serum_ldh; label: Serum LDH (U/L); type: number; placeholder: e.g. 200
  • id: uln_ldh; label: Upper limit of normal serum LDH (U/L); type: number; placeholder: e.g. 220

Clinical pearls

  • Light's criteria misclassify ~25% of transudates as exudates in patients on diuretics — use serum-to-fluid albumin gradient (>1.2 = transudate)
  • pH <7.2 in a parapneumonic effusion is the strongest indication for chest tube drainage
  • Malignant effusions are exudates in >95% of cases

Source and review

  • Light RW et al. Ann Intern Med 1972. Last reviewed: 2025-01-01