Bedside noninvasive detection of acute pulmonary embolism in critically ill surgical patients.

HYPOTHESIS: We hypothesized that late pulmonary dead space fraction (Fd(late)) would be a useful tool to screen for pulmonary embolism (PE) in a group of surgical patients, including patients who required mechanical ventilation and patients with adult respiratory distress syndrome.

DESIGN

We prospectively calculated Fd(late) in patients with suspected PE who underwent pulmonary angiography.

SETTING

University-based, level I trauma center.

MAIN OUTCOME MEASURE: Ability of Fd(late) to identify patients with PE.

RESULTS

Twelve patients had 14 angiograms for suspected PE. The Fd(late) was 0.12 or above in all 5 patients who had PE; 4 required mechanical ventilation. The Fd(late) values were below 0.12 in 8 of 9 patients without PE. Four patients had adult respiratory distress syndrome. The Fd(late) had 100% sensitivity and 89% specificity for the detection of PE.

CONCLUSIONS

The Fd(late) is a valuable tool for bedside screening of PE in surgical patients. We were able to accurately detect all PEs.