Bedside noninvasive detection of acute pulmonary embolism in critically ill surgical patients.
OBJECTIVE
We hypothesized that late pulmonary dead space fraction (Fd(late)) would be a useful tool to screen for pulmonary embolism (PE) in a group of surgical patients, including patients who required mechanical ventilation and patients with adult respiratory distress syndrome.


METHODS
We prospectively calculated Fd(late) in patients with suspected PE who underwent pulmonary angiography.


METHODS
University-based, level I trauma center.


METHODS
Ability of Fd(late) to identify patients with PE.


RESULTS
Twelve patients had 14 angiograms for suspected PE. The Fd(late) was 0.12 or above in all 5 patients who had PE; 4 required mechanical ventilation. The Fd(late) values were below 0.12 in 8 of 9 patients without PE. Four patients had adult respiratory distress syndrome. The Fd(late) had 100% sensitivity and 89% specificity for the detection of PE.


CONCLUSIONS
The Fd(late) is a valuable tool for bedside screening of PE in surgical patients. We were able to accurately detect all PEs.
Anderson
J T
JT
Department of Surgery, University of California, Davis, Health System, Sacramento, USA.
Owings
J T
JT
Goodnight
J E
JE
D000328:Adult; D001944:Breath Tests; D002245:Carbon Dioxide / Q000032:analysis; D016638:Critical Illness; D005260:Female; D006801:Humans; D008297:Male; D019095:Point-of-Care Systems; D011651:Pulmonary Artery / Q000000981:diagnostic imaging; D011655:Pulmonary Embolism / Q000150:complications / Q000175:diagnosis*; D011859:Radiography; D012121:Respiration, Artificial; D012126:Respiratory Dead Space; D012128:Respiratory Distress Syndrome / Q000150:complications; D012129:Respiratory Function Tests; D012680:Sensitivity and Specificity
D002245:Carbon Dioxide