Does pleural fluid pH change significantly at room temperature during the first hour following thoracentesis?

BACKGROUND Usually, pleural fluid (PF) pH is measured immediately following thoracentesis, and if there is any delay in the measurement, the PF sample is preserved on ice. OBJECTIVE To determine if PF pH changes significantly at room temperature during the first hour following thoracentesis. DESIGN Prospective, self-controlled. SETTING Tertiary care center. PATIENTS All patients undergoing thoracentesis. MEASUREMENTS The PF pH of a sample collected in an arterial blood gas syringe was measured immediately following thoracentesis by an arterial blood pH/gas analyzer. Additional measurements were made at 5, 15, 30, 45, and 60 min from the first pH measurement (pH0), maintained at room temperature. RESULTS For 28 PF samples, pH0 (mean +/- SD) was 7.351 +/- 0.158, and the 60-min pH (pH60) was 7.359 +/- 0.161. The mean difference between pH60 and pH0 was 0.008 +/- 0.026, which was not significant, either clinically or statistically (p = 0.13). Similarly, the interim pH values (for measures at 5, 15, 30, 45 min after pH0) were not significantly different from pH0 (mean differences, 0.002, 0.003, 0.005, and 0.004, respectively; p values, 0.51, 0.21, 0.06, and 0.22, respectively). CONCLUSIONS The pleural fluid pH of a sample preserved at room temperature does not change significantly during the first hour following thoracentesis. Hence, contrary to the common medical practice, there is no need to perform the pH measurement within minutes after thoracentesis and to preserve a pleural fluid sample on ice.