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💧 Light's Criteria (Pleural Effusion)

UseEnter pleural and serum protein, pleural and serum LDH, and the serum LDH upper limit of normal; the tool eva…

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SourceRoberts ME, et al. BTS Guideline for pleural disease 2023. Thorax. 2023;78(Suppl 3):s1-s42.

Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders

This-shift next steps

After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.

Score + version; reference only — not a substitute for care · no HIS write

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Methodology · worked example, guidelines & full notes
Clinical takeaway

Light's criteria are highly sensitive for exudates but occasionally misclassify a transudate (e.g., diuretic-treated heart failure) as exudate. (original synthesis · not guideline verbatim)

When to use

Enter pleural and serum protein, pleural and serum LDH, and the serum LDH upper limit of normal; the tool evaluates all three criteria. An exudate prompts a search for local pleural disease (infection, malignancy, inflammation).

How it works

Exudate if any: pleural/serum protein > 0.5; OR pleural/serum LDH > 0.6; OR pleural LDH > 2/3 × serum LDH upper limit of normal. Otherwise transudate.

Key points

  • Light's criteria are highly sensitive for exudates but occasionally misclassify a transudate (e.g., diuretic-treated heart failure) as exudate. (original synthesis · not guideline verbatim)
  • When a transudate is strongly suspected clinically yet criteria are only marginally met, a serum-pleural albumin gradient > 12 g/L supports a transudate.
  • Always interpret alongside fluid appearance, cell count/differential, glucose, pH, cytology, and microbiology rather than in isolation.

References

Worked calculation

The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.

Pleural protein40 g/L
Serum protein70 g/L
Pleural LDH250 U/L
Serum LDH200 U/L
Serum LDH upper limit of normal245 U/L

→DeterminationExudate

  • Protein ratio > 0.5:0.57 ✓
  • LDH ratio > 0.6:1.25 ✓
  • Pleural LDH > 2/3 ULN:250 vs 163 ✓
Verification & sources · governance
FAQ

Frequently asked questions

What are the limits and cautions when using Light's Criteria (Pleural Effusion)?
For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
Does Light's Criteria (Pleural Effusion) upload patient data? Where is it calculated?
Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
How is Light's Criteria (Pleural Effusion) calculated in practice? Can you show a worked example?
Inputs: Pleural protein 40 g/L, Serum protein 70 g/L, Pleural LDH 250 U/L, Serum LDH 200 U/L, Serum LDH upper limit of normal 245 U/L → Result: Determination Exudate(Protein ratio > 0.5: 0.57 ✓, LDH ratio > 0.6: 1.25 ✓, Pleural LDH > 2/3 ULN: 250 vs 163 ✓)
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