The Alveolar-Arterial Oxygen Gradient in Patients With Documented Pulmonary Embolism

Overton, David; Bocka, Joseph J.

doi:10.1001/archinte.1988.00380070107025

Cited by 34 publications

(1 citation statement)

References 36 publications

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“…That the finding of a normal PaO 2 does not necessarily exclude the diagnosis of PE was also documented by Overton and Bockton [17], who found normal PaO 2 values in 7% of patients with established PE.…”

Section: Discussionmentioning

confidence: 64%

Diagnostic value of gas exchange tests in patients with clinical suspicion of pulmonary embolism

et al. 1999

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Objective: To assess the value of parameters derived from arterial blood gas tests in the diagnosis of pulmonary embolism. Method:We measured alveolar-arterial partial pressure of oxygen [P(A-a)O 2 ] gradient, PaO 2 and arterial partial pressure of carbon diaxide (PaCO 2 ) in 773 consecutive patients with suspected pulmonary embolism who were enrolled in the Prospective Investigative Study of Acute Pulmonary Embolism. Diagnosis:The study design required pulmonary angiography in all patients with abnormal perfusion scans. Results:Of 773 scans, 270 were classified as normal/near-normal and 503 as abnormal. Pulmonary embolism was diagnosed by pulmonary angiography in 312 of 503 patients with abnormal scans. Of 312 patients with pulmonary embolism, 12, 14 and 35% had normal P(A-a)O 2 , PaO 2 and PaCO 2 , respectively. Of 191 patients with abnormal scans and negative angiograms, 11, 13 and 55% had normal P(A-a)O 2 , PaO 2 and PaCO 2 , respectively. The proportions of patients with normal/near-normal scans who had normal P(A-a)O 2 , PaO 2 and PaCO 2 were 20, 25 and 37%, respectively. No differences were observed in the mean values of arterial blood gas data between patients with pulmonary embolism and those who had abnormal scans and negative angiograms. Among the 773 patients with suspected pulmonary embolism, 364 (47%) had prior cardiopulmonary disease. Pulmonary embolism was diagnosed in 151 (41%) of 364 patients with prior cardiopulmonary disease, and in 161 (39%) of 409 patients without prior cardiopulmonary disease. Among patients with pulmonary embolism, there was no difference in arterial blood gas data between patients with and those without prior CPD. Conclusion:These data indicate that arterial blood gas tests are of limited value in the diagnostic work-up of pulmonary embolism if they are not interpreted in conjunction with clinical and other laboratory tests.

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Section: Discussionmentioning

confidence: 64%

Diagnostic value of gas exchange tests in patients with clinical suspicion of pulmonary embolism

et al. 1999

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Arterial Blood Gases and the Alveolar‐Arterial Oxygen Difference in Acute Pulmonary Embolism

Stein

2007

Pulmonary Embolism

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Arterial blood gases and the alveolar–arterial oxygen difference in acute pulmonary embolism

2016

Pulmonary Embolism

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The Alveolar-Arterial Oxygen Gradient in Patients With Documented Pulmonary Embolism

Cited by 34 publications

References 36 publications

Diagnostic value of gas exchange tests in patients with clinical suspicion of pulmonary embolism

Diagnostic value of gas exchange tests in patients with clinical suspicion of pulmonary embolism

Arterial Blood Gases and the Alveolar‐Arterial Oxygen Difference in Acute Pulmonary Embolism

Arterial blood gases and the alveolar–arterial oxygen difference in acute pulmonary embolism

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