Pulmonary embolism arterial blood gas analysis
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Editor(s)-In-Chief: C. Michael Gibson, M.S., M.D. [1], The APEX Trial Investigators; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]
Synonyms and keywords: ABG
Overview
Hypoxemia, hypocapnia, increased alveolar-arterial gradient, and respiratory alkalosis are the typical findings that may be observed in patients with pulmonary embolism (PE). The absence of the typical results of the arterial blood gas (ABG) analysis, however, does not exclude PE.[1] ABG analysis results does not contribute reliably to tailoring the management of the patients among whom PE is suspected.[2]
Arterial Blood Gas Analysis
- The above mentioned typical 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.
- Combined respiratory and metabolic acidosis in cases of massive PE
- The absence of the typical results of the arterial blood gas (ABG) analysis, however, does not exclude PE.[1] ABG analysis results does not contribute reliably to tailoring the management of the patients among whom PE is suspected.[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
- ↑ 1.0 1.1 Stein PD, Goldhaber SZ, Henry JW, Miller AC (1996). "Arterial blood gas analysis in the assessment of suspected acute pulmonary embolism". Chest. 109 (1): 78–81. PMID 8549223.
- ↑ 2.0 2.1 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) - ↑ 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) - ↑ 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) - ↑ 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)