tailieunhanh - Báo cáo y học: "Splendors and miseries of expired CO2 measurement in the suspicion of pulmonary embolism"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Splendors and miseries of expired CO2 measurement in the suspicion of pulmonary embolism. | Verschuren and Perrier Critical Care 2010 14 110 http content 14 1 110 CRITICAL CARE COMMENTARY L__ Splendors and miseries of expired CO2 measurement in the suspicion of pulmonary embolism Franck Verschuren1 and Arnaud Perrier2 See related research article by Rumpf etal. http content 13 6 R196 Abstract Capnography has been studied for decades as a potential diagnostic tool for suspected pulmonary embolism. Despite technological refinements and its combination with other non-invasive instruments no evidence to date allows recommending the use of expired carbon dioxide measurement as a rule-out test for pulmonary embolism without additional radiological testing. Further investigations are however still warranted. In the previous issue of Critical Care Rumpf and colleagues 1 evaluated the potential contribution of measuring end-tidal carbon dioxide CO2 for suspected pulmonary embolism PE in the prehospital setting. Capnography has been studied for decades as a potential diagnostic tool for patients with suspected PE. Indeed PE is expected to create areas of reduced arterial flow with normal or increased alveolar ventilation resulting in increased alveolar dead space volume and reduced global expired CO2. This should create a difference between arterial and end-tidal CO2 values as first demonstrated by Robin and colleagues 2 in 1959. However during the two following decades several authors pointed out the numerous pitfalls and sources of errors in assessing the arterial to end-tidal CO2 difference in the clinical suspicion of PE and this test was finally abandoned until the nineties 3-5 . Three elements explain the current resurgence of expired CO2 measurement in the suspicion of PE. First Correspondence 2Division of General Internal Medicine Geneva University Hospital and Faculty of Medicine 4 rue Gabrielle-Perret-Gentil CH-1211 Geneva 14 Switzerland Full list of author information is available at the end of the

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