Open AccessDIFFERENCES BETWEEN END-TIDAL CARBON DIOXIDE OBTAINED IN RIGHT AND LEFT LATERAL DECUBITUS POSITIONS IN A PATIENT WITH A PULMONARY EMBOLISM – A CONCEPT FOR USAGE IN EMERGENCY MEDICINE
Author(s) -
Dorota Zyśko,
Grzegorz Gogolewski,
Goutam Chourasia,
Joanna Wizowska,
Maciej Guziński,
Dariusz Jagielski,
Dariusz Timler,
Klaudiusz Nadolny
Publication year - 2020
Publication title -
emergency medical service
Language(s) - English
Resource type - Journals
ISSN - 2391-7822
DOI - 10.36740/emems202003102
Subject(s) - medicine , pulmonary embolism , pulmonary artery , capnography , embolism , shock (circulatory) , cardiology , radiology , anesthesia
The aim: To diagnose patients with suspected pulmonary embolism is to assess eTCO2 in two lateral decubitus positionsand to compare them between each other and with PaCO2.Material and methods: An approval of the bioethics commission was obtained to study eTCO2 in different positions in patientswith suspected PE (583/2019). Consecutive ED patients referred for computed tomography pulmonary angiography (CTPA) dueto a suspicion of pulmonary artery embolism are asked to take part in the study. Exclusion criteria are the inability to give informedconsent, shock or hypotension, inability to change position (an elevation of the upper body to 30 degrees is allowed). The otheravailable laboratory data like D-dimer concentration, troponin, arterial blood gases analysis, creatinine, sodium, potassium,NT-proBNP, hemoglobin, C-reactive protein, and glycemia are noted. CTPA in the case of pulmonary embolism is assessed todetermine differences between embolism to both lungs.Results: The difference between eTCO2 on the left lateral decubitus position was found. Contrary to this finding ina healthy person there was no differences between eTCO2 obtained in both lateral positions. Stress tests are knownmethods for examining patients whose underlying conditions are normal or inconclusive. In the case of capnography,such a load could be a change in body position, which is a simple procedure that does not require much physical effort.Conclusions: Intensifying efforts to disseminate knowledge on the use of eTCO2 in clinical practice and to find new applicationsfor this study seems particularly important.