Variáveis capnográficas pré e pós-tromboendarterectomias pulmonares

Abstract

In these case report, the results of late dead space fraction (fDlate), end-tidal alveolar dead space fraction (AVDSf), arterial-alveolar gradient CO2 [P(a-et)CO2], and slope phase 3 of spirogram of two patients who underwent thromboendarterectomy for pulmonary embolism (PE) are shown. PE was diagnosed by pulmonary scintigraphy, helical tomography, and pulmonary angiography. The calculation of fDlate, AVDSf and P(a-et)CO2 was based on volumetric capnography associated with arterial blood gas analysis. The pre-operative fDlate of the first patient was 0.16 (cutoff 0.12) and AVDSf was 0.30 (cutoff 0.15). However, the fDlate of the second patient was false-negative (0.01) but, the AVDSf was positive (0.28). Postoperative fDlate of the first patient was -0.04 and AVDSf was 0.16; for the second patient, the values were 0.07 and 0.28, respectively. The association of these capnographic variables with image exams reinforces the importance of this noninvasive diagnosis method.

Volumetric capnography: In the diagnostic work-up of chronic thromboembolic disease

“…In the literature, we observe the following higher cut-off values for the studied variables: 0.15 for AVDSf,6 0.12 for fDlate,7 and 5 mmHg for P(a-et)CO 2 8. Considering the fact that a higher calculated value indicates greater obstruction of the vascular system (and a larger alveolar dead space), we infer that there is a correlation between the extent of the area without perfusion and the value obtained 3–5. In this patient, the result of VCap variations were displayed in imaging results.…”

“…The association of VCap variables with ABGA allows for the calculation of several indices, the variations of which can infer the presence of occlusion or improve after treatment of pulmonary vessels 3–5…”

Methodological adequacy of articles published in two open-access Brazilian cardiology periodicals

“… 8 - 11 In Revista Brasileira de Cirurgia Cardiovascular, different sections were found, for example: Special Article, Brief Communication, Clinical Surgical Correlation and Experience of the Service. 12 - 14 …”

Alveolar dead space and capnographic variables before and after thrombolysis in patients with acute pulmonary embolism

“…This was due to the fact that the opening of the vascular beds by removal of thrombotic material resulted in great improvement of pulmonary perfusion and consequent reduction in the volume of alveolar dead space. Moreira and colleagues conducted two studies: one evaluating two capnography variables (AVDSf and fDlate) in a patient with chronic pulmonary hypertension due to exacerbation of PE,12 and another evaluating the same capnographic variables in two patients submitted to surgical embolectomy 9. The authors demonstrated that AVDSf and fDlate both correlated with the findings of imaging studies, their values moving closer to reference values as the imaging test results improved.…”