Bedside End Tidal Carbon Dioxide in Evaluation for Pulmonary Embolism. (Record no. 3661)

MARC details
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fixed length control field 03444nam a22003737a 4500
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fixed length control field 180818s20182018 xxu||||| |||| 00| 0 eng d
022 ## - INTERNATIONAL STANDARD SERIAL NUMBER
International Standard Serial Number 1069-6563
024 ## - OTHER STANDARD IDENTIFIER
Standard number or code 10.1111/acem.13546 [doi]
040 ## - CATALOGING SOURCE
Original cataloging agency Ovid MEDLINE(R)
099 ## - LOCAL FREE-TEXT CALL NUMBER (OCLC)
PMID 30084149
245 ## - TITLE STATEMENT
Title Bedside End Tidal Carbon Dioxide in Evaluation for Pulmonary Embolism.
251 ## - Source
Source Academic Emergency Medicine. 2018 Aug 06
252 ## - Abbreviated Source
Abbreviated source Acad Emerg Med. 2018 Aug 06
253 ## - Journal Name
Journal name Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Year 2018
260 ## - PUBLICATION, DISTRIBUTION, ETC.
Manufacturer FY2019
266 ## - Date added to catalog
Date added to catalog 2018-08-16
501 ## - WITH NOTE
Local holdings Available online from MWHC library: 1997 - present, Available in print through MWHC library:2005-2007
520 ## - SUMMARY, ETC.
Abstract Copyright This article is protected by copyright. All rights reserved.
520 ## - SUMMARY, ETC.
Abstract Pulmonary embolism (PE) is associated with approximately 100,000 deaths per year in the United States and the incidence of deep vein thrombosis/pulmonary embolism in the US is estimated at more than 350,000 cases annually (1). The diagnosis of pulmonary embolism poses a diagnostic challenge in the Emergency Department (ED), despite, validated decision rules, lab tests, and radiographic imaging (2, 3). While a simple lab test would be ideal for diagnosis, the well-known D-dimer test is, at its best, only about 54% specific (4). The gold standard pulmonary artery Computed Tomography Angiography (CTA) has numerous downsides including a requirement of clinical stability for transport to radiology, administration of potentially nephrotoxic contrast agents, and radiation exposure to patients, some of whom may be pregnant. Hemodynamically significant PE increases pulmonary dead space and therefore increases the alveolar dead space fraction, however calculating this involves invasive testing with ABG and a slightly cumbersome calculation (5, 6). Studies suggest that it is possible to use ETCO2 alone to screen for PE with the resultant increase in dead space causing the amount of exhaled ETCO2 to be lower in patients with clinically significant PE as opposed to invasive ABG testing (7, 8). However, these studies have typically included patients admitted to the hospital, which represent a fraction of those seen in the ED, and likely have a higher prevalence of PE. No study has prospectively evaluated real-time ETCO2 in ED patients suspected of having PE. We sought to determine if ETCO2 can rule out hemodynamically significant PE, hypothesizing that no patients with hemodynamically significant PE would have an ETCO2 greater than 35 mm Hg. Our secondary hypothesis was that the mean ETCO2 would be significantly lower in patients with PE versus those without PE. Full IRB approval was obtained through MedStar Washington Hospital Center's IRB prior to initiation of this study. This article is protected by copyright. All rights reserved.
546 ## - LANGUAGE NOTE
Language note English
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Topical term or geographic name entry element IN PROCESS -- NOT YET INDEXED
651 ## - SUBJECT ADDED ENTRY--GEOGRAPHIC NAME
Institution MedStar Health Research Institute
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Institution MedStar Washington Hospital Center
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Department Emergency Medicine
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Medline publication type Journal Article
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Local Authors Goyal, Munish
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Local Authors Mete, Mihriye
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Local Authors Wallis, Marianne C
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Local Authors Wilson, Matthew
790 ## - Authors
All authors Goyal M, Koroshetz L, Mete M, Soares R, Wallis MC, Wilson MD
856 ## - ELECTRONIC LOCATION AND ACCESS
DOI <a href="https://dx.doi.org/10.1111/acem.13546">https://dx.doi.org/10.1111/acem.13546</a>
Public note https://dx.doi.org/10.1111/acem.13546
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Koha item type Journal Article
Item type description Article
Holdings
Withdrawn status Lost status Damaged status Not for loan Collection Home library Current library Date acquired Total Checkouts Full call number Barcode Date last seen Price effective from Koha item type
          MedStar Authors Catalog MedStar Authors Catalog 08/16/2018   30084149 30084149 08/16/2018 08/16/2018 Journal Article

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