Because of these facts, a bedside noninvasive screening test that could accurately exclude the diagnosis of PE in patients without PE and identify patients with a high likelihood of PE is urgently needed. The transportation of patients who required mechanical ventilation for either of these diagnostic studies is further associated with major risks. Unfortunately, the currently available diagnostic studies, ventilation-perfusion scan and pulmonary angiogram, are cumbersome, invasive, and expensive. Because the treatment of PE, anticoagulation, can be associated with substantial risks and even death, overdiagnosis is similarly problematic. 3 The consequence of failing to diagnose or delaying the correct diagnosis of PE may be death. 1, 2 Initial signs and symptoms are varied and nonspecific. Pulmonary embolism occurs relatively infrequently, in about 1% to 2% of trauma patients, 1, 2 and it is fatal in about 25% to 50% of these cases. PULMONARY embolism (PE) presents the clinician with a difficult diagnostic dilemma.

We were able to accurately detect all PEs. The Fd late had 100% sensitivity and 89% specificity for the detection of PE.Ĭonclusions The Fd late is a valuable tool for bedside screening of PE in surgical patients. Four patients had adult respiratory distress syndrome. The Fd late values were below 0.12 in 8 of 9 patients without PE. The Fd late was 0.12 or above in all 5 patients who had PE 4 required mechanical ventilation. Results Twelve patients had 14 angiograms for suspected PE. Main Outcome Measure Ability of Fd late to identify patients with PE. Setting University-based, level I trauma center. Hypothesis 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.ĭesign We prospectively calculated Fd late in patients with suspected PE who underwent pulmonary angiography.

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Formula for physiological dead space