| Title: | Capnometry in suspected pulmonary embolism with positive D-dimer on the field |
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| Authors: | ID Hernja Rumpf, Tadeja (Author)
ID Križmarić, Miljenko (Author)
ID Grmec, Štefek (Author) |
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| Files: |  Critical_Care_2009_Rumpf,_Krizmaric,_Grmec_Capnometry_in_suspected_pulmonary_embolism_with_positive_D-dimer_in_the_field.pdf (397,36 KB)
MD5: B2587BB7AD58B2EEEB00993FD611760D
 http://ccforum.biomedcentral.com/articles/10.1186/cc8197
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| Language: | English |
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| Work type: | Scientific work |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: | FZV - Faculty of Health Sciences
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| Abstract: | 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. |
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| Keywords: | capnometry, pulmonary embolism, D-dimer |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2009 |
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| Number of pages: | str. 1-9 |
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| Numbering: | Letn. 13 |
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| PID: | 20.500.12556/DKUM-66510  |
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| ISSN: | 1466-609X |
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| UDC: | 616.24-005-083.98 |
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| ISSN on article: | 1466-609X |
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| COBISS.SI-ID: | 3502399 |
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| DOI: | 10.1186/cc8197 |
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| NUK URN: | URN:SI:UM:DK:5DLNX1S8 |
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| Publication date in DKUM: | 29.06.2017 |
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| Views: | 1696 |
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| Downloads: | 386 |
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| Metadata: |    |
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| Categories: | Misc.
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