Skip to main content
Article thumbnail
Location of Repository

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

By Marcos Mello Moreira, Renato G G Terzi, Carlos Heitor N Carvalho, Antonio Francisco de Oliveira Neto, Mônica Corso Pereira and Ilma Aparecida Paschoal


Pulmonary embolism (PE) is a common condition. The central aim of this study was to describe the use of volumetric capnography (VCap) before and after fibrinolytic treatment of major PE. Lung scintigraphy was used as a base of comparison for the results of this treatment. We describe the cases of two conscious and spontaneously breathing patients (20- and by 24-year-old women) with major PE undergoing thrombolysis. Curves of CO2 were obtained VCap and associated with arterial blood gas analysis and D-dimer. The pattern of VCap was compared with the VCap of health volunteers. Parameters also calculated were: P(a-et)CO2 gradient, alveolar dead space fraction (AVDSf ), late dead space fraction (fDlate), and slope phase III (Slp III). The VCap results before and after thrombolysis for patients 1 and 2 were, respectively, P(a-et)CO2: 12.6 to 5.8 and 7.9 to 1.6 (mmHg); AVDSf: 0.46 to 0.18 and 0.25 to 0.05; fDlate: 0.46 to 0.21 and 0.24 to 0.04; Slp III: 1.75 to 5.10 and 1.21 to 5.61 (mmHg/L). Lung scintigraphy was used to compare VCap results from the two subjects with VCap results from healthy volunteers and pigs before and after treatment associated with arterial blood gas, D-dimer, and showed satisfactory agreement

Topics: Case Report
Publisher: Dove Medical Press
OAI identifier:
Provided by: PubMed Central
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • http://www.pubmedcentral.nih.g... (external link)
  • Suggested articles


    1. (1997). Association between thrombolytic treatment and the prognosis of hemodynamically stable patients with major pulmonary embolism: results of a multicenter registry. Circulation.
    2. (2007). Captação de oxigênio e eliminação de gás carbônico na embolia pulmonar experimental – avaliação pela gasometria arterial e capnografi a volumétrica. Medicina Intensiva.
    3. Diagnosis of pulmonary embolism based upon alveolar dead space analysis.
    4. (2005). Fração tardia do espaço morto (fDlate) antes e após embolectomia pulmonar. Rev Bras Cir Cardiovasc.
    5. Heparin plus alteplase compared with heparin alone in patients with submassive pulmonary embolism.
    6. (2004). Impact of a rapid rule-out protocol for pulmonary embolism on the rate of screening, missed cases, and pulmonary vascular imaging in an urban US emergency department. Ann Emerg Med.
    7. (1993). Microemboli reduce phase III slopes of CO2 and invert phase III slopes of infused SF6. Respir Physiol.
    8. Noninvasive evaluation of pulmonary disease using volumetric capnography in adult patients with cystic fi brosis. J Cyst Fibros. 2007;Supplement I:S38.
    9. PaCO2/ETCO2 gradient: early indicator of thrombolysis effi cacy in a massive pulmonary embolism.
    10. (1963). Spirometric studies in normal subjects. III. Static lung volumes and maximum voluntary ventilation in adults with a note on physical fi tness. Acta Med Scand.
    11. (2006). The bedside investigation of pulmonary embolism diagnosis study. Arch Intern Med.
    12. (2007). Variáveis capnográfi cas pré e pós embolectomias pulmonares – Comunicação Prévia. Rev Bras Cir Cardiovasc.
    13. (2004). Volumetric capnography as a bedside monitoring of thrombolysis in major pulmonary embolism. Intensive Care Med.
    14. Volumetric capnography as a noninvasive diagnostic procedure in acute pulmonary thromboembolism.
    15. (1995). Volumetric capnography in children: Influence of growth on the alveolar plateau slope.

    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.