IMPROVED USE OF ARTERIAL BLOOD-GAS ANALYSIS IN SUSPECTED PULMONARY-EMBOLISM
IMPROVED USE OF ARTERIAL BLOOD-GAS ANALYSIS IN SUSPECTED PULMONARY-EMBOLISM
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DOI：
10.1378/chest.95.1.48
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发表时间：
1989-01-01
期刊：
影响因子：
9.6
通讯作者：
MARINO, PL
中科院分区：
文献类型：
--
作者：
CVITANIC, O;MARINO, PL
由于低氧血症不是急性肺栓塞的敏感指标，我们进行了一项回顾性研究，以确定P(A-a)O2梯度增加或低碳酸血症是否改善了急性栓塞血气分析的敏感性。研究组包括78名有血管造影记录的栓子患者，他们在呼吸室内空气时采集了血气样本。没有人有过心肺疾病的病史。低氧血症59例(76%)，低氧血症或低碳酸血症73例(93%)，P(A-a)O2梯度增加74例(95%)，P(A-a)O2梯度增加77例(98%)。仅1例急性栓塞者P(A-a)O2梯度正常，PaCO2呼吸室空气正常。这些结果表明，患者在室内空气呼吸时获得的正常P(A-a)O2梯度和正常PaCO2可以作为肺血栓存在的证据。
Since hypoxemia is not known to be a sensitive indicator of acute pulmonary embolism, we performed a retrospective study to determine whether an increased P(A-a)O2 gradient or hypocapnia improved the sensitivity of blood gas analysis in acute embolism. The study group consisted of 78 patients with angiographically documented emboli who had blood gas samples obtained while breathing room air. None had a prior history of cardiopulmonary disease. Hypoxemia was percent in 59 patients (76 percent), hypoxemia or hypocapnia in 73 patients (93 percent), an increased P(A-a)O2 gradient in 74 patients (95 percent), and an increased P(A-a)O2 gradient or hypocapnia in 77 patients (98 percent). Only one patient with acute embolism showed a normal P(A-a)O2 gradient and normal PaCO2 breathing room air. These results suggest that a normal P(A-a)O2 gradient and a normal PaCO2 obtained in a patient during room air breathing can be used as evidence against the presence of pulmonary emboli.