Bedside Noninvasive Detection of Acute Pulmonary Embolism in Critically Ill Surgical Patients
John T. Anderson, MD;
John T. Owings, MD;
James E. Goodnight, MD, PhD
Arch Surg. 1999;134:869-875.
Hypothesis We hypothesized that late pulmonary dead space fraction (Fdlate) 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.
Design We prospectively calculated Fdlate in patients with suspected PE who underwent pulmonary angiography.
Setting University-based, level I trauma center.
Main Outcome Measure Ability of Fdlate to identify patients with PE.
Results Twelve patients had 14 angiograms for suspected PE. The Fdlate was 0.12 or above in all 5 patients who had PE; 4 required mechanical ventilation. The Fdlate values were below 0.12 in 8 of 9 patients without PE. Four patients had adult respiratory distress syndrome. The Fdlate had 100% sensitivity and 89% specificity for the detection of PE.
Conclusions The Fdlate is a valuable tool for bedside screening of PE in surgical patients. We were able to accurately detect all PEs.
From the Department of Surgery, University of California, Davis, Health System, Sacramento.
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