Pulmonary embolism arterial blood gas analysis

Revision as of 15:24, 8 March 2013 by Ochuko Ajari (talk | contribs)
Jump to navigation Jump to search

Pulmonary Embolism Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Pulmonary Embolism from other Diseases

Epidemiology and Demographics

Risk Factors

Triggers

Natural History, Complications and Prognosis

Diagnosis

Diagnostic criteria

Assessment of Clinical Probability and Risk Scores

Pulmonary Embolism Assessment of Probability of Subsequent VTE and Risk Scores

History and Symptoms

Physical Examination

Laboratory Findings

Arterial Blood Gas Analysis

D-dimer

Biomarkers

Electrocardiogram

Chest X Ray

Ventilation/Perfusion Scan

Echocardiography

Compression Ultrasonography

CT

MRI

Treatment

Treatment approach

Medical Therapy

IVC Filter

Pulmonary Embolectomy

Pulmonary Thromboendarterectomy

Discharge Care and Long Term Treatment

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Follow-Up

Support group

Special Scenario

Pregnancy

Cancer

Trials

Landmark Trials

Case Studies

Case #1

Pulmonary embolism arterial blood gas analysis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Pulmonary embolism arterial blood gas analysis

CDC on Pulmonary embolism arterial blood gas analysis

Pulmonary embolism arterial blood gas analysis in the news

Blogs on Pulmonary embolism arterial blood gas analysis

Directions to Hospitals Treating Pulmonary embolism arterial blood gas analysis

Risk calculators and risk factors for Pulmonary embolism arterial blood gas analysis

Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], The APEX Trial Investigators; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Synonyms and keywords:: ABG

Overview

Hypoxemia, hypocapnia, increased alveolar-arterial gradient, and respiratory alkalosis are common findings that may be observed in patients with pulmonary embolism. In patients with suspected PE, Rodger et al, demonstrated that ABG analysis did not have sufficient negative predictive value, specificity, or likelihood ratios to be considered useful in the management these patients.[1] Similar findings were observed by the PIOPED II investigators.[2]

Arterial Blood Gas Analysis

Findings

  • The above mentioned ABG findings are not exclusive for the diagnosis of PE. Some variations include:
    • Hypercapnia in cases of massive PE secondary to circulatory collapse.
    • Normal PaO2 (partial pressure of oxygen in arterial blood) levels as demonstrated by the majority of patients.[4]
    • Normal alveolar-arterial oxygen gradient may be observed in ~6% of patients.

Sensitivity and Specificity

In patients with suspected PE, Rodger et al, demonstrated that ABG analysis did not have sufficient negative predictive value, specificity, or likelihood ratios to be considered useful in the management these patients.[1] Similar findings were observed by the PIOPED II investigators.[2]

Pulse Oximetry

The value of pulse oximetry in the diagnosis of pulmonary embolism is limited. In 2003, Kline et al, demonstrated that a room-air pulse oximetry reading of ≥ 95% at diagnosis was associated with a significantly lower probability of in-hospital complications from pulmonary embolism and hence may be used as a prognostic marker.[5]

References

  1. 1.0 1.1 Rodger MA, Carrier M, Jones GN, Rasuli P, Raymond F, Djunaedi H, Wells PS (2000). "Diagnostic value of arterial blood gas measurement in suspected pulmonary embolism". American Journal of Respiratory and Critical Care Medicine. 162 (6): 2105–8. PMID 11112122. Retrieved 2012-04-30. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 Stein PD, Woodard PK, Weg JG, Wakefield TW, Tapson VF, Sostman HD, Sos TA, Quinn DA, Leeper KV, Hull RD, Hales CA, Gottschalk A, Goodman LR, Fowler SE, Buckley JD (2006). "Diagnostic pathways in acute pulmonary embolism: recommendations of the PIOPED II investigators". The American Journal of Medicine. 119 (12): 1048–55. doi:10.1016/j.amjmed.2006.05.060. PMID 17145249. Retrieved 2012-04-30. Unknown parameter |month= ignored (help)
  3. Cvitanic O, Marino PL (1989). "Improved use of arterial blood gas analysis in suspected pulmonary embolism". Chest. 95 (1): 48–51. PMID 2491801. Retrieved 2012-04-30. Unknown parameter |month= ignored (help)
  4. Stein PD, Terrin ML, Hales CA, Palevsky HI, Saltzman HA, Thompson BT, Weg JG (1991). "Clinical, laboratory, roentgenographic, and electrocardiographic findings in patients with acute pulmonary embolism and no pre-existing cardiac or pulmonary disease". Chest. 100 (3): 598–603. PMID 1909617. Retrieved 2012-04-30. Unknown parameter |month= ignored (help)
  5. Kline JA, Hernandez-Nino J, Newgard CD, Cowles DN, Jackson RE, Courtney DM (2003). "Use of pulse oximetry to predict in-hospital complications in normotensive patients with pulmonary embolism". The American Journal of Medicine. 115 (3): 203–8. PMID 12935827. Retrieved 2012-05-01. Unknown parameter |month= ignored (help)

Template:WH Template:WS