Pre And Post-pulmonary Thromboendarterectomies Campnographic Variables [variáveis Capnográficas Pré E Pós- Tromboendarterectomias Pulmonares]

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)CO 2 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.224509512Eriksson, L., Wollmer, P., Olsson, C.G., Diagnosis of pulmonary embolism based upon alveolar dead space analysis (1989) Chest, 96 (2), pp. 357-362Rodger, M.A., Jones, G., Rasuli, P., Raymond, F., Djunaedi, H., Bredeson, C.N., Steady-state end-tidal alveolar dead space fraction and D-dimer: Bedside tests to exclude pulmonary embolism (2001) Chest, 120 (1), pp. 115-119Moreira, M.M., Terzi, R.G.G., Vieira, R.W., Petrucci Jr, O., Fração tardia do espaço morto (fDlate) antes e após embolectomia pulmonar. (2005) Rev Bras Cir Cardiovasc, 20 (1), pp. 81-84Grimby, G., Söderholm, B., Spirometric studies in normal subjects. III Static lung volumes and maximum voluntary ventilation in adults with a note on physical fitness (1963) Acta Med Scand, 173, pp. 199-205Verschuren, F., Heinonen, E., Clause, D., Roeseler, J., Thys, F., Meert, P., Volumetric capnography as a bedside monitoring of thrombolysis in major pulmonary embolism (2004) Intensive Care Med, 30 (11), pp. 2129-2132Thys, F., Elamly, A., Marion, E., Roeseler, J., Janssens, P., El Gariani, A., PaCO(2)/ETCO(2) gradient: Early indicator of thrombolysis efficacy in a massive pulmonary embolism (2001) Resuscitation, 49 (1), pp. 105-108Paschoal, I.A., Moreira, M.M., Pereira, S.T., Noninvasive evaluation of pulmonary disease using volumetric capnography in adult patients with chronic pulmonary obstructive disease (2007) J Cystic Fibrosis, 6 (SUPPL. I), pp. S38Rodger, M.A., Bredeson, C.N., Jones, G., Rasuli, P., Raymond, F., Clement, A.M., The bedside investigation of pulmonary embolism diagnosis study: A double-blind randomized controlled trial comparing combinations of 3 bedside tests vs ventilation-perfusion scan for the initial investigation of suspected pulmonary embolism (2006) Arch Intern Med, 166 (2), pp. 181-18