Author/Authors :
karakayalı, onur derince training and research hospital - department of emergency medicine, Turkey , yılmaz, serkan kocaeli derince training and research hospital, Turkey , ertok, ilyas ankara training and research hospital, Turkey , çelik, gülhan kurtoğlu ankara atatürk training and research hospital, Turkey , pamukcu, gül ankara atatürk training and research hospital, Turkey , yiğit, yavuz kocaeli derince training and research hospital, turkey , memiş, murat gölbaşı state hospital, Turkey , yıldırım, halil aksaray state hospital - radiology department, Turkey
Abstract :
Objective: The purpose of our study was to investigate the relationship between the pulmonary artery obstruction index (PAOI) assessed with helical computed tomography (CT) and impairment in blood gases in patients with acute pulmonary embolism (PE). Method: This retrospective study design was carried out in the Tertiary Training and Research Hospital Emergency Clinic over a 6-month period with patients in whom PE was detected. The Alveolar–arterial (A-a) oxygen gradient for oxygen was calculated according to the formula 150 – 1.25 (PaCO2 – PaO2), and the PAOI for each patient was measured with the Qanadli score at the mediastinal window using chest CT angiography (CTA). Results: There were 113 patients included in the study; their mean age was 61.40 (±16.082) years and 51.4% of the patients were female. The mean Alveolar–arterial (A-a) oxygen gradient value was 65.13(±18.78) in massive embolism group. The mean PAOI was determined as 34.027 (min:7.5, max:83.7). The relationship between the radiologically measured PAOI and the Alveolar–arterial (A-a) oxygen gradient were compared, and an increase in the index was detected as the Alveolar– arterial (A-a) oxygen gradient level increased; this difference was found to be statistically significant (r=0.400; p 0.001). Conclusions: This retrospective observational study found a weak but positive correlation between the PAOI and the Alveolar–arterial (A-a) oxygen gradient. Our study showed that consideration of the Alveolar–arterial (A-a) oxygen gradient increases the sensitivity of blood gas analysis in documented pulmonary embolism.All data showed that the Alveolar–arterial (A-a) oxygen gradient values may be clinically beneficial, as such testing is easy to perform and cost-effective.Moreover, it can be performed at the bedside to detect which patients should be treated with thrombolytics.
