Alveolar dead space and capnographic variables before and after thrombolysis in patients with acute pulmonary embolism

Author(s)

Moreira, Marcos Mello ; Terzi, Renato G. G. ; Carvalho, Carlos Heitor N. ; de Oliveira Neto, Antonio Francisco ; Pereira, Monica Corso ; Paschoal, Ilma Aparecida

• Document type: Journal article
• Source: VASCULAR HEALTH AND RISK MANAGEMENT; v. 5, p. 4-pg., 2009-01-01.

Abstract

Pulmonary embolism (PE) is a common condition. The central aim of this study was to describe the use of volumetric capnography (VCap) before and after fi brinolytic treatment of major PE. Lung scintigraphy was used as a base of comparison for the results of this treatment. We describe the cases of two conscious and spontaneously breathing patients (20-and 24-year-old women) with major PE undergoing thrombolysis. Curves of CO2 were obtained by VCap and associated with arterial blood gas analysis and D-dimer. The pattern of VCap was compared with the VCap of health volunteers. Parameters also calculated were: P(a-et) CO2 gradient, alveolar dead space fraction (AVDSf), late dead space fraction (f Dlate), and slope phase III (Slp III). The VCap results before and after thrombolysis for patients 1 and 2 were, respectively, P(a-et) CO2 : 12.6 to 5.8 and 7.9 to 1.6 (mmHg); AVDSf: 0.46 to 0.18 and 0.25 to 0.05; f Dlate: 0.46 to 0.21 and 0.24 to 0.04; Slp III: 1.75 to 5.10 and 1.21 to 5.61 (mmHg/L). Lung scintigraphy was used to compare VCap results from the two subjects with VCap results from healthy volunteers and pigs before and after treatment associated with arterial blood gas, D-dimer, and showed satisfactory agreement. (AU)