Light's Criteria Calculator

Determine if pleural effusion is exudate or transudate using protein and LDH ratios

Critical Medical Disclaimer

This calculator is for educational purposes only and should NOT be used for medical diagnosis or treatment decisions.

  • Light's criteria interpretation requires comprehensive clinical assessment
  • Laboratory values must be obtained simultaneously from pleural fluid and serum
  • Additional clinical factors, imaging, and symptoms are essential for diagnosis
  • Always consult a pulmonologist or physician for proper pleural effusion evaluation

Light's Criteria Assessment

Protein concentration in pleural fluid sample

g/dL

Protein concentration in blood serum (same time as pleural sample)

U/L

Lactate dehydrogenase in pleural fluid

U/L

Lactate dehydrogenase in blood serum

U/L

Laboratory-specific upper normal limit for LDH (varies between labs, typically 200-250 U/L)

Light's Criteria Results

⏳ PENDING
Enter laboratory values to determine fluid type
Protein Ratio
0.00
<0.5 (Transudate)
LDH Ratio
0.00
<0.6 (Transudate)
LDH/Upper Limit
0.00
<0.67 (Transudate)

Interpretation: Enter laboratory values for classification

Formula: Protein ratio = Pleural protein ÷ Serum protein; LDH ratio = Pleural LDH ÷ Serum LDH

Clinical Significance

Example Calculations

Exudate Example (Pneumonia)

Pleural protein: 4.2 g/dL, Serum protein: 6.8 g/dL

Pleural LDH: 350 U/L, Serum LDH: 200 U/L, Upper normal: 250 U/L

Protein ratio: 4.2÷6.8 = 0.62 (≥0.5 ✓)

LDH ratio: 350÷200 = 1.75 (≥0.6 ✓)

LDH/Upper limit: 350÷250 = 1.40 (≥0.67 ✓)

Result: Exudate (3/3 criteria met)

Transudate Example (Heart Failure)

Pleural protein: 1.8 g/dL, Serum protein: 6.2 g/dL

Pleural LDH: 110 U/L, Serum LDH: 190 U/L, Upper normal: 250 U/L

Protein ratio: 1.8÷6.2 = 0.29 (<0.5 ✗)

LDH ratio: 110÷190 = 0.58 (<0.6 ✗)

LDH/Upper limit: 110÷250 = 0.44 (<0.67 ✗)

Result: Transudate (0/3 criteria met)

Light's Criteria

Exudate Criteria (≥1 required)

Protein ratio:≥ 0.5
LDH ratio:≥ 0.6
LDH/Upper limit:≥ 0.67

Additional Parameters

Protein (exudate):> 3.5 g/dL
Protein (transudate):< 2.5 g/dL

Common Causes

Exudate

• Pneumonia/Infection
• Malignancy
• Pulmonary embolism
• Tuberculosis
• Rheumatic diseases
• Pancreatitis

Transudate

• Heart failure
• Liver cirrhosis
• Nephrotic syndrome
• Hypoalbuminemia
• Atelectasis
• Hypothyroidism

Clinical Notes

Blood and pleural fluid samples must be drawn simultaneously

Upper normal LDH limit varies by laboratory (typically 200-250 U/L)

Light's criteria has 98% sensitivity for exudates

Consider clinical context - some heart failure cases may meet exudate criteria

Understanding Light's Criteria

What are Light's Criteria?

Light's criteria are laboratory-based rules used to distinguish between exudative and transudative pleural effusions. Developed by Dr. Richard Light in 1972, these criteria help determine the underlying cause of fluid accumulation in the pleural space.

Clinical Importance

  • Guides diagnostic workup and treatment approach
  • 98% sensitivity for detecting exudates
  • Helps prioritize further investigations
  • Assists in determining need for pleural biopsy

Pathophysiology

Exudates: Result from increased capillary permeability or impaired lymphatic drainage due to inflammation, infection, or malignancy.
Transudates: Result from imbalance in hydrostatic and oncotic pressures across normal pleural membranes.

Important: Light's criteria should be interpreted with clinical context. Some conditions like heart failure on diuretics may occasionally meet exudate criteria.

Diagnostic Algorithm

Step 1: Obtain Samples

Collect simultaneous pleural fluid and serum samples for protein and LDH analysis.

Step 2: Apply Criteria

Calculate ratios and determine if any of the three Light's criteria are met for exudate classification.

Step 3: Clinical Correlation

Integrate results with clinical presentation, imaging, and additional tests as needed.