20.500.12556/DKUM-66510 Capnometry in suspected pulmonary embolism with positive D-dimer on the field Introduction: Pulmonary embolism (PE) is one of the greatest diagnostic challenges in prehospital emergency setting. Most patients with suspected PE have a positive D-dimer and undergo diagnostic testing. Excluding PE with additional non-invasive tests would reduce the need for further imaging tests. We aimed to determine the effectiveness of combination of clinical probability and end-tidal carbon dioxide (PetCO2) for evaluation of suspected PE with abnormal concentrations of D-dimer in prehospital emergency setting. Methods: We assessed clinical probability of PE and PetCO2 measurement in 100 consecutive patients with suspected PE and positive D-dimer in the field. PetCO2 > 28 mmHg was considered as the best cut-off point. PE was excluded or confirmed by hospital physicians in the University Clinical Center Maribor by computer tomography (CT), ventilation/ perfusion scan echocardiography and pulmonary angiography. Results: PE was confirmed in 41 patients. PetCO2 had a sensitivity of 92.6% (95% CI, 79 to 98%), a negative predictive value of 94.2 % (95% CI, 83 to 99%), a specificity of 83 % (95% CI, 71 to 91%) and a positive predictive value of 79.2% (95% CI, 65 to 89%). Thirty-five patients (35%) had both a low (PE unlikely) clinical probability and a normal PetCO2 (sensitivity: 100%, 95% CI: 89 to 100%) and twenty-eight patients (28%) had both a high clinical probability (PE likely) and abnormal PetCO2 (specificity: 93.2%, 95% CI: 83 to 98%). Conclusions: The combination of clinical probability and PetCO2 may safely rule out PE in patients with suspected PE and positive D-dimer in the prehospital setting. capnometry pulmonary embolism D-dimer kapnometrija pljučna embolija D-dimer true false true Angleški jezik Slovenski jezik Znanstveno delo 2017-06-29 09:32:46 2017-06-29 09:33:54 2022-07-11 03:07:24 2019-07-11 15:49:55 2009 0 0 str. 1-9 Letn. 13 2009 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 1466-609X 616.24-005-083.98 1137983 3502399 10.1186/cc8197 1466-609X URN:SI:UM:DK:5DLNX1S8 Critical_Care_2009_Rumpf,_Krizmaric,_Grmec_Capnometry_in_suspected_pulmonary_embolism_with_positive_D-dimer_in_the_field.pdf Critical_Care_2009_Rumpf,_Krizmaric,_Grmec_Capnometry_in_suspected_pulmonary_embolism_with_positive_D-dimer_in_the_field.pdf 1 B2587BB7AD58B2EEEB00993FD611760D d4e5db7f6c4410076780036a90d4ffb1227e2cf2443362ed7a50fd75376c3b24 51dc1f2a-7c0e-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=113319 http://ccforum.biomedcentral.com/articles/10.1186/cc8197 1 https://dk.um.si/Dokument.php?lang=slv&id=113318 Fakulteta za zdravstvene vede 0 0 0