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Year : 2021  |  Volume : 10  |  Issue : 1  |  Page : 37

PaCO2–EtCO2 gradient and D-dimer in the diagnosis of suspected pulmonary embolism

Departments of Emergency Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Correspondence Address:
Dr. Maryam Mottaghi
Departments of emergency medicine, Isfahan University of Medical Sciences, Isfahan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/abr.abr_10_20

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Background: The diagnosis of pulmonary embolism (PE) because of nonspecific clinical presentation remains as a challenge for emergency physicians. Arterial to end-tidal partial pressure of carbon dioxide (P(a-Et)CO2) gradient may be useful in the evaluation of PE. This aimed to define the diagnostic role of P(a-Et)CO2 gradient by sidestream capnography, as a noninvasive method, and D-dimer in patients with PE. Materials and Methods: Two hundred and three patients with chest pain or dyspnea who attend the hospital emergency ward were enrolled over a study period at a single academic center. PE was confirmed by multidetector computed tomography (MDCT) scans. PaCO2, EtCO2, and D-dimer were measured within 24 h of MDCT by capnograph. Results: The combination of P(a-Et)CO2 gradient (cutoff >9.2 ng/ml) and D-dimer (cutoff >3011 ng/ml) with sensitivity and specificity of 30.2% and 87.2% showed a significant diagnostic value in detecting PE (area under the curve = 0.577, P = 0.045) but not alone (P > 0.05). Conclusion: As the results show, the combination of P(a-Et)CO2 gradient and D-dimer can show an acceptable diagnostic value in detecting PE, although it suggests further research on evaluating the diagnostic value of P(a-Et)CO2 gradient and combining it with other diagnostic criteria to achieve a definite and generalizable result.

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