Evaluation of suspected pulmonary embolism utilizing end-tidal CO2 and D-dimer

Jason M. Johanning, Thomas J. Veverka, Ronald A. Bays, George K. Tong, Susan K. Schmiege

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Abstract

Background: The study prospectively assesses deadspace [(arterial CO2 - end-tidal CO2)/arterial CO2] and the D-dimer assay as a rapid, noninvasive alternative for evaluating pulmonary embolism in critically ill patients.Methods: Group I patients had nonemergency baseline arterial blood gas and end-tidal CO2 recorded. If patients experienced respiratory distress, D-dimer with repeat arterial blood gas and end-tidal CO2 were obtained. Patients emergently intubated without baseline laboratory studies (group II) had arterial blood gas, end-tidal CO2, and D-dimer obtained.Results: A significant increase (P <0.001) in deadspace was noted with pulmonary embolism (0.43 [0.08], range 0.30 to 0.51, n = 7) versus without (0.21 [0.15], range 0.00 to 0.43, n = 14). Patients in group 1 with pulmonary embolism demonstrated increased deadspace (P <0.026, 0.28 [0.01] to 0.39 [0.13], n = 2) from baseline compared with decreased deadspace (P <0.001, 0.20 [0.09] to 15 [0.16], n = 9) without pulmonary embolism. D-dimer levels >1,000 ng/mL were present in all patients with pulmonary embolism.Conclusions: The study demonstrates the ability of deadspace and D-dimer to exclude and potentially diagnose pulmonary embolism. Copyright (C) 1999 Excerpta Medica Inc.

Original languageEnglish (US)
Pages (from-to)98-102
Number of pages5
JournalAmerican journal of surgery
Volume178
Issue number2
DOIs
StatePublished - Aug 1 1999

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Pulmonary Embolism
Gases
Critical Illness
fibrin fragment D

ASJC Scopus subject areas

  • Surgery

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Evaluation of suspected pulmonary embolism utilizing end-tidal CO2 and D-dimer. / Johanning, Jason M.; Veverka, Thomas J.; Bays, Ronald A.; Tong, George K.; Schmiege, Susan K.

In: American journal of surgery, Vol. 178, No. 2, 01.08.1999, p. 98-102.

Research output: Contribution to journalArticle

Johanning, Jason M. ; Veverka, Thomas J. ; Bays, Ronald A. ; Tong, George K. ; Schmiege, Susan K. / Evaluation of suspected pulmonary embolism utilizing end-tidal CO2 and D-dimer. In: American journal of surgery. 1999 ; Vol. 178, No. 2. pp. 98-102.
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N2 - Background: The study prospectively assesses deadspace [(arterial CO2 - end-tidal CO2)/arterial CO2] and the D-dimer assay as a rapid, noninvasive alternative for evaluating pulmonary embolism in critically ill patients.Methods: Group I patients had nonemergency baseline arterial blood gas and end-tidal CO2 recorded. If patients experienced respiratory distress, D-dimer with repeat arterial blood gas and end-tidal CO2 were obtained. Patients emergently intubated without baseline laboratory studies (group II) had arterial blood gas, end-tidal CO2, and D-dimer obtained.Results: A significant increase (P <0.001) in deadspace was noted with pulmonary embolism (0.43 [0.08], range 0.30 to 0.51, n = 7) versus without (0.21 [0.15], range 0.00 to 0.43, n = 14). Patients in group 1 with pulmonary embolism demonstrated increased deadspace (P <0.026, 0.28 [0.01] to 0.39 [0.13], n = 2) from baseline compared with decreased deadspace (P <0.001, 0.20 [0.09] to 15 [0.16], n = 9) without pulmonary embolism. D-dimer levels >1,000 ng/mL were present in all patients with pulmonary embolism.Conclusions: The study demonstrates the ability of deadspace and D-dimer to exclude and potentially diagnose pulmonary embolism. Copyright (C) 1999 Excerpta Medica Inc.

AB - Background: The study prospectively assesses deadspace [(arterial CO2 - end-tidal CO2)/arterial CO2] and the D-dimer assay as a rapid, noninvasive alternative for evaluating pulmonary embolism in critically ill patients.Methods: Group I patients had nonemergency baseline arterial blood gas and end-tidal CO2 recorded. If patients experienced respiratory distress, D-dimer with repeat arterial blood gas and end-tidal CO2 were obtained. Patients emergently intubated without baseline laboratory studies (group II) had arterial blood gas, end-tidal CO2, and D-dimer obtained.Results: A significant increase (P <0.001) in deadspace was noted with pulmonary embolism (0.43 [0.08], range 0.30 to 0.51, n = 7) versus without (0.21 [0.15], range 0.00 to 0.43, n = 14). Patients in group 1 with pulmonary embolism demonstrated increased deadspace (P <0.026, 0.28 [0.01] to 0.39 [0.13], n = 2) from baseline compared with decreased deadspace (P <0.001, 0.20 [0.09] to 15 [0.16], n = 9) without pulmonary embolism. D-dimer levels >1,000 ng/mL were present in all patients with pulmonary embolism.Conclusions: The study demonstrates the ability of deadspace and D-dimer to exclude and potentially diagnose pulmonary embolism. Copyright (C) 1999 Excerpta Medica Inc.

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