The diagnostic role of capnography in pulmonary embolism.
The aim of this study was to evaluate the diagnostic contribution of alveolar dead space fraction (AVDSf) measured using capnography in patients admitted with suspected pulmonary embolism (PE). A total of 58 patients who were admitted to our hospital with suspected PE between October 2006 and January 2008 were included in this study. All patients were assessed using the Wells clinical score, capnography, computed tomographic pulmonary angiography, D-dimer measurement, lower-extremity venous Doppler ultrasonography, and V/Q scintigraphy. Forty patients (69%) had PE based on computed tomographic pulmonary angiography findings. The AVDSf value with the highest sensitivity and specificity, which was at the same time statistically significant, was 0.09. This value was consistent with the AVDSf value obtained using receiver operating characteristic analysis. In our study, the sensitivity of capnography was 70%, with a specificity of 61.1%, positive predictive value of 80%, and negative predictive value of 47.8%. The use of AVDSf in combination with any of the several scoring systems that evaluate clinical likelihood of PE and D-dimer levels resulted in higher sensitivity and specificity rates for the diagnosis of PE.
Kurt
Ozlem Kar
OK
Department of Chest Diseases, Ataturk Chest Disease and Thoracic Surgery Teaching and Research Hospital, 06280 Ankara, Turkey. aghhozlem@yahoo.com
Alpar
Sibel
S
Sipit
Tugrul
T
Guven
Selma Firat
SF
Erturk
Hakan
H
Demirel
Mikail Koray
MK
Korkmaz
Meliha
M
Hayran
Mutlu
M
Kurt
Bahar
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019296:Capnography; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011655:Pulmonary Embolism / Q000175:diagnosis* / Q000000981:diagnostic imaging; D012372:ROC Curve; D011859:Radiography; D012680:Sensitivity and Specificity; D015898:Tomography Scanners, X-Ray Computed; D055815:Young Adult
D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D