Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients

Akbas, Ibrahim; Koçak, Ahmet; Çelik, Beste; Menekşe, Tuğba Sanalp; Demir, Mesut; Gür, Şükrü; Kerget, Buğra; Çakır, Zeynep

doi:10.4149/bll_2021_008

Cited by 4 publications

(4 citation statements)

References 28 publications

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“…the mean value of respiratory rate was 28/min, the mean value of blood oxygen saturation was 88% (without oxygen compensation), while the mean value of the heart rate was 88.5/min. 18 for heart rate, no statistical significance was shown in our study in relation to the group of patients who were excluded from the diagnosis of Pe. According to the literature consulted, dyspnea was present in more than 70% of patients in our study.…”

Section: Discussioncontrasting

confidence: 82%

Diagnosis of pulmonary embolism in the Emergency Department

Rošić

Kočet

Simić

et al. 2022

ACC

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The aim of this study was to determine the association of clinical presentation, the Wells scoring system and D-dimer values with mSCt pulmonary angiography. A case control study was conducted in the emergency Department of the Clinical hospital Sveti Duh throughout 2019. Patients with a referral diagnosis of a pulmonary embolism were included in the study. Patients were divided into two groups. The first group consisted of patients diagnosed with pulmonary embolism by mSCt pulmonary angiography or postmortem, and the second group consisted of patients excluded from pulmonary embolisms. for the Wells score, D-dimers, troponin, respiratory rate and peripheral blood oxygen saturation, statistically significant differences were found between groups of patients with confirmed or excluded pulmonary embolism (p <0.001). for heart rate, chest pain, syncope, and hemoptysis, no statistically significant differences were found between these two groups of patients. Deep venous thrombosis of the lower extremities was found by ultrasound in > 70% of patients with massive a pulmonary embolism. Pulmonary embolism was confirmed in all patients for whom a high risk was calculated according to the Wells score. in conclusion, a low degree of clinical probability (according to the Wells score), along with a normal concentration of D-dimer, are a sure strategy in excluding pulmonary embolism.

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Section: Discussioncontrasting

confidence: 82%

Diagnosis of pulmonary embolism in the Emergency Department

Rošić

Kočet

Simić

et al. 2022

ACC

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“…It has been reported that IPI = 1 in sedated patients for PEG placement showed a good sensitivity of 81% for hypoxic events, but its speci city was low and IPI was not superior to isolated EtCO 2 monitoring [4]. In the study reporting that IPI has a high predictive value for pulmonary embolism in patients presenting to the emergency department with dyspnoea, the IPI cut-off value was ≤ 2, and the sensitivity and speci city of IPI for this value were 100.0% and 96.0%, respectively [30]. In contrast to the respiratory studies in the literature, one study compared the IPI with other cardiac risk scores in acute coronary syndrome and found that the IPI score had a sensitivity of 83.0% and a speci city of 74.3% in predicting major cardiovascular events [31].…”

Section: Discussionmentioning

confidence: 93%

The Use of End-Tidal CO2 and Integrated Pulmonary Index to Predict Postspinal Hypotension in Cesarean Section

ASLANLAR,

ALHARACH,

ASLANLAR

et al. 2023

Preprint

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Purpose Postspinal hypotension (PSH) is one of the most important complications in obstetric anesthesia, and early diagnosis and treatment reduces the risk of maternofetal complications. Integrated pulmonary index (IPI) is an algorithm that uses real-time measurements of four parameters: end tidal carbon dioxide (EtCO2), respiratory rate (RR), heart rate (HR) and peripheral oxygen saturation (SpO2). In this study, the effect of EtCO2 and IPI in predicting PSH was investigated. Methods Patients scheduled for cesarean section under spinal anesthesia under elective conditions were included in the study. A capnography device (Capnostream 35; Medtronic, Inc.) was used for IPI assessment. A decrease of 20% or more in the baseline blood pressure value or a decrease in systolic blood pressure below 100 mmHg after spinal anesthesia was considered postspinal hypotension. The correlation between developing hypotension and EtCO2 and IPI measurements was analyzed. Results PSH developed in 63.4% of the 82 patients included in the study. EtCO2 and IPI values decreased significantly compared to baseline values in patients who developed PSH. While IPI difference was not found to be an independent risk factor in predicting PSH, the amount of change in EtCO2 was found to be diagnostic (AUC: 0.90 (0.83-0.97; p<0.001). According to the cut-off value of 2.5 for the amount of change in EtCO2, sensitivity was 80.8%, specificity 90.0%, positive predictive value 93.3% and negative predictive value 73.0%. Conclusion EtCO2 monitoring can be used as a reliable new technique for early diagnosis and treatment of postspinal hypotension in cesarean section. ClinicalTrials Registration: NCT05237856

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“…It has been reported that IPI = 1 in sedated patients for PEG placement showed a good sensitivity of 81% for hypoxic events, but its specificity was low and the IPI was not superior to isolated EtCO 2 monitoring [ 4 , 5 ]. In the study reporting that IPI has a high predictive value for pulmonary embolism in patients presenting to the emergency department with dyspnoea, the IPI cut-off value was ≤2, and the sensitivity and specificity of IPI for this value were 100.0% and 96.0%, respectively [ 26 ]. In contrast with the respiratory studies in the literature, one study compared the IPI with other cardiac risk scores in acute coronary syndrome and found that the IPI score had a sensitivity of 83.0% and a specificity of 74.3% in predicting major cardiovascular events [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

The Use of End-Tidal CO2 and Integrated Pulmonary Index to Predict Postspinal Hypotension in Cesarean Section

Aslanlar,

Alharach,

Kara

et al. 2023

JCM

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Early diagnosis and treatment of postspinal hypotension (PSH) in obstetric anaesthesia reduces the risk of maternofetal complications. In this study, the effect of EtCO2 and the integrated pulmonary index (IPI) in predicting PSH was investigated. Patients scheduled for cesarean section under spinal anaesthesia were included. The Capnostream 35 respiratory monitor (Medtronic, Inc., Dublin, Ireland) was used for EtCO2 and IPI. PSH developed in 52 (63.4%) of the 82 patients. EtCO2 and IPI values decreased significantly compared with baseline values in patients who developed PSH. There were statistically significant differences in EtCO2 (p = 0.001) and the IPI change (p = 0.045) in patients who developed PSH compared with those who did not. It was found that the EtCO2 difference had an independent effect on predicting PSH (p < 0.05), whereas the IPI difference did not (p > 0.05). One unit decrease in EtCO2 from the baseline increased the risk of PSH by 3.3 times. ROC curve analysis showed that the magnitude of change in EtCO2 was diagnostic for predicting PSH (AUC: 0.90 (0.83–0.97; p < 0.001)). IPI showed no predictive value for postspinal hypotension in cesarean section. However, EtCO2 monitoring, which is non-invasive and real-time monitoring, can be used to predict postspinal hypotension.

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Performance of integrated pulmonary index for pulmonary embolism in dyspneic patients

Cited by 4 publications

References 28 publications

Diagnosis of pulmonary embolism in the Emergency Department

Diagnosis of pulmonary embolism in the Emergency Department

The Use of End-Tidal CO2 and Integrated Pulmonary Index to Predict Postspinal Hypotension in Cesarean Section

The Use of End-Tidal CO2 and Integrated Pulmonary Index to Predict Postspinal Hypotension in Cesarean Section

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