Falsely high refractometric readings for the specific gravity of pleural fluid.

For 128 pleural fluids, the relationship between the protein content and the reading for the specific gravity obtained from a refractometer calibrated for urinary specific gravity was analyzed. The refractometer gave falsely high levels for the specific gravity of the pleural fluid. A reading for 1.019 (rather than 1.016) corresponded to a concentration of protein of 3.0 gm/100 ml, and each deviation of 0.005 (rather than 0.003) coresponded to a concentration of 1 gm/100 ml; however, determinations of the concentration of protein in the pleural fluid directly from the refractometer's scale for protein (calibrated for serum) was rapid and accurate. Calculation of the protein content of the pleural fluid from the reading for specific gravity on the refractometer is erroneous and sometimes misleading.