Can alveolar—arterial oxygen gradient predict severity of pulmonary embolism?

Abdelghany, Elham Abdelhady; Othman, Ashraf M.; Abdelfatah, Rasha Abdelraof; Magdy, Mohammed-Elhoseany; Elghany, Hosny S Abd; Higazi, Mahmoud M.

doi:10.4103/ejb.ejb_62_18

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Arterial blood samples were collected to determine the partial pressure of arterial oxygen (PaO 2 ), arterial carbon dioxide (PaCO 2 ), and the alveolar -arterial oxygen (A-a O 2 ) gradient equation was calculated (17).…”

Section: Mean Platelet Volume (Mpv)mentioning

confidence: 99%

Prognostic value of laboratory markers in patients with acute pulmonary embolism

Ahmed,

Elfadl,

Houssein

et al. 2024

Preprint

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Background Acute pulmonary embolism (APE) is a serious illness. Identifying prognostic factors for APE may help in the management of those patients. This study's objective was to evaluate the prognostic value of laboratory markers in predicting right ventricular dysfunction (RVD) and 30-day mortality in pulmonary embolism patients. Methods Eighty patients with APE were enrolled and followed up for 30-day. Detailed echocardiography was done to evaluate RVD. All patients were subjected to arterial blood gas analysis, complete blood count (CBC), plasma concentration of C-reactive protein (CRP), serum D-dimer level, and serum troponin I level, and the following ratio were calculated: Neutrophil to lymphocytic ratio (NLR), Platelet to lymphocytic ratio (PLR), Red cell distribution width (RDW), Mean platelet volume (MPV) and alveolar to arterial gradient. Results Our results analysis revealed significantly elevated levels of median NLR, PLR, CRP, D-dimer, and troponin in both the RVD and non-survivor groups (P value < 0.001). The blood markers that showed the highest predictive ability for right ventricular dysfunction (RVD) and 30-day mortality, as determined by receiver operating characteristic (ROC) analysis and logistic regression, were A-a O2 gradient, serum troponin, CRP, D-dimer, NLR, and PLR (P value < 0.001). Conclusion Evaluation of different serum markers including NLR, PLR, RDW, CRP, D-dimer, troponin and A-a O2 gradient are simple and available markers for predicting right ventricular dysfunction (RVD) and 30- day mortality in patients with APE. Trial registration: ClinicalTrials.gov ID: NCT04237974.

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Section: Mean Platelet Volume (Mpv)mentioning

confidence: 99%

Prognostic value of laboratory markers in patients with acute pulmonary embolism

Ahmed,

Elfadl,

Houssein

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

Prognostic value of laboratory markers in patients with acute pulmonary embolism

Omar,

Ahmed,

Elfadl

et al. 2024

Egypt J Bronchol

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Background Acute pulmonary embolism (APE) is a serious illness. Identifying prognostic factors for APE may help in the management of those patients. This study’s objective was to evaluate the prognostic value of laboratory markers in predicting right ventricular dysfunction (RVD) and 30-day mortality in pulmonary embolism patients. Methods Eighty patients with APE were enrolled and followed up for 30 days. Detailed echocardiography was done to evaluate RVD. All patients were subjected to arterial blood gas analysis, complete blood count (CBC), plasma concentration of C-reactive protein (CRP), serum D-dimer level, and serum troponin I level, and the following ratio were calculated: neutrophil-to-lymphocytic ratio (NLR), platelet to lymphocytic ratio (PLR), red cell distribution width (RDW), mean platelet volume (MPV), and alveolar to arterial gradient. Results Our results analysis revealed significantly elevated levels of median NLR, PLR, CRP, D-dimer, and troponin in both the RVD and non-survivor groups (P value < 0.001). The blood markers that showed the highest predictive ability for right ventricular dysfunction (RVD) and 30-day mortality, as determined by receiver operating characteristic (ROC) analysis and logistic regression, were A-a O2 gradient, serum troponin, CRP, D-dimer, NLR, and PLR (P value < 0.001). Conclusion Evaluation of different serum markers including NLR, PLR, RDW, CRP, D-dimer, troponin, and A-a O2 gradient is a simple and available marker for predicting right ventricular dysfunction (RVD) and 30-day mortality in patients with APE. Trial registration ClinicalTrials.gov ID: NCT04237974.

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Prevalence and characteristics of venous thromboembolism in severe exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in India

Meitei

Tale

Kumar

et al. 2021

Monaldi Arch Chest Dis

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Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dimer above the age adjusted cut-off underwent computerised tomography pulmonary angiography (CTPA). Results were analysed using SPSS version 23. Sixteen (10.3%) patients had VTE, 15 (93.75%) of them being cases of isolated PE. Female gender, higher cumulative past exposure to corticosteroid, higher alveolar-arterial gradient, right ventricular dysfunction, and higher mean pulmonary artery pressure were associated with increased risk for VTE. The prevalence of VTE in AECOPD in this study among an Indian population is higher than among other Asians, but lower than among the Blacks, the Caucasians and the Middle-East ethnicities. Since a vast majority of VTE presents as PE without DVT in the setting of AECOPD, the absence of deep vein thrombosis of lower limbs does not rule PE in the setting.

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Can alveolar—arterial oxygen gradient predict severity of pulmonary embolism?

Cited by 3 publications

References 17 publications

Prognostic value of laboratory markers in patients with acute pulmonary embolism

Prognostic value of laboratory markers in patients with acute pulmonary embolism

Prognostic value of laboratory markers in patients with acute pulmonary embolism

Prevalence and characteristics of venous thromboembolism in severe exacerbation of chronic obstructive pulmonary disease in a tertiary care hospital in India

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