Prognostic Role Of Aa Do2 In Acute Pulmonary Embolism

Prognostic Role of Alveolar-arterial Oxygen Pressure Difference (AaDO2) in Acute Pulmonary Embolism Hsu Jen Te

Introduction ,[object Object],[object Object]

ICOPER: Mortality 11.4% at 2week & 17.4 at 3 months

Acute Pulmonary Embolism ,[object Object],[object Object],[object Object]

Four processes cause arterial hypoxaemia due to inefficient pulmonary gas exchange : ,[object Object],[object Object],[object Object],[object Object]

ABG analysis have proved disappointing as diagnostic modalities ,[object Object],[object Object],[object Object]

Paper reviews ,[object Object],[object Object]

Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED) study ,[object Object],[object Object],[object Object]

Our interests ,[object Object]

Methods and Materials CMRGP 650031

Including criteria ,[object Object],[object Object],[object Object]

Excluding criteria ,[object Object],[object Object],[object Object],[object Object]

Treatment ,[object Object],[object Object],[object Object]

Clinical features and biochemical data ,[object Object],[object Object],[object Object]

Artery blood gas analysis ,[object Object],[object Object],[object Object],[object Object]

The arterial/Alveolar oxygen tension ratio(a/APO2 : an index of gas exchange applicable to varying inspired oxygen concentrations) Gilbert and Karetzky et al. American review of respiratory disease 1974

Stability of the arterial/alveolar oxygen partial pressure ratio: effects of low ventilation/perfusion regions. Gilbert el al. Critical care medicine 1979

Clinical Endpoints ,[object Object],[object Object],[object Object]

Statistical analysis ,[object Object],[object Object],[object Object],[object Object]

Results ,[object Object],[object Object],[object Object]

Table 1. Clinical characteristics, echocardiographic parameters, and cardiac troponin I in PE survivors and patients who died at 30 days.

Table 2. Clinical characteristics, echocardiographic parameters, and cardiac troponin I in the 30-day composite-event free group vs. the 30-day composite event group

30-day mortality & composite event rate ,[object Object],[object Object]

Parameters influences primary end point ,[object Object],[object Object],[object Object],[object Object],[object Object]

Additive parameters influences secondary end point ,[object Object],[object Object],[object Object],[object Object],[object Object]

The analytical findings have not been published ,[object Object]

Incidence of thrombocytopenia ,[object Object],[object Object]

Figure 1. ROC curves for variable artery blood gas analysis.

Figure 2. ROC curves for AaDO2 and a/APO2-R ,[object Object],[object Object],[object Object]

The optimal cut-off value for AaDO2 was 53mmHg. ,[object Object],[object Object],[object Object]

A prognostic cut-off value of a/APO2 ratio was 0.49 ,[object Object]

Figure 3. Survival curves at 1 year, based on a cut-off values of AaDO2≥53mmHg vs. AaDO2<53mmHg ,[object Object],[object Object]

Figure 4. Composite event-free survival curves at 1 year, based on cut-off values of AaDO2≥53mmHg vs. AaDO2<53mmHg ,[object Object],[object Object]

What is the role of AaDO2 analysis in patients with documented pulmonary embolism? ,[object Object],[object Object],[object Object]

AaDO2≧53mmHg ,[object Object],[object Object],[object Object]

Future investigation plan ,[object Object]

The role of a/APO2 analysis in patients with documented pulmonary embolism. ,[object Object],[object Object],[object Object]

In the real word, blood gas analysis could be checked under variable FIO2 ,[object Object],[object Object]

a prognostic cut-off value of a/APO2 ratio was 0.49 ,[object Object],[object Object],[object Object]

There was conflicting result about hypoxemia. ,[object Object],[object Object],[object Object],[object Object]

The mechanism for widening AaDO2 and hypoxemia . ,[object Object],[object Object],[object Object],[object Object]

Thrombocytopenia has a significant role in acute pulmonary embolism . ,[object Object],[object Object],[object Object]

Study limitation ,[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object],[object Object]

Conclusion 2 ,[object Object],[object Object]

一個不經意的小發現，卻帶給我們喜悅的心情

Prognostic Role Of Aa Do2 In Acute Pulmonary Embolism

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Prognostic Role Of Aa Do2 In Acute Pulmonary Embolism