Correlation of alveolar-arterial gradient with computed tomography pulmonary artery obstruction index in acute pulmonary embolism

Akut pulmoner embolide alveolar-arterial oksijen gradient'in kompüterize tomografi pulmoner arter obstruksiyon indeksi ile korelasyonu

Serkan YILMAZ, Gül PAMUKCU, Gülhan ÇELİK KURTOĞLU, Yavuz YİĞİT, Murat MEMİŞ, Onur KARAKAYALI, Halil YILDIRIM, İlyas ERTOK

Özet

Amaç: Çalışmamızın amacı akut pulmoner emboli saptanan hastalarda helikal bilgisayarlı tomografi ile hesaplanan pulmoner arter obstruksiyon indeksinin (PAOI) kan gazı parametrelerinden alveolar-arterial oksijen gradienti ile ilişkisinin araştırılmasıdır. Yöntem: Bu retrospektif çalışmaya 3. Basamak eğitim araştırma hastanesi acil tıp kliniğine 6 aylık dönemde başvuran ve pulmoner emboli tespit edilen hastalar dahil edildi. Alveolar-arterial oksijen gradient ''150-1,25(PaCO2-Pa02)'' formülu ile hesaplandı. Bulgular: Çalışmaya 113 hasta dahil edildi. Hastaların yaş ortalaması 61.40 (±16,082) ve %51.4' ü bayandı. Alveolar-arterial oksijen gradient ortalaması masif emboli grubunda 65,13 (±18,78) saptandı. PAOI ortalaması 34,027 (min:7,5 max:83,7) idi. PAOI ile alveolar-arterial oksijen gradienti arasındaki ilişki karşılaştırıldığında alveolar-arterial oksijen gradienti yükseldikçe pulmoner arter obstruksiyon indeksinin arttığı ve bu ilişkinin istatistiksel olarak anlamlı olduğu görüldü (r=0,400 p

Abstract

Objective: The purpose of our study was to investigate the relationship between the pulmonary artery obstruction index (PAOI) assessed with helical computed tomography (CT) and impairment in blood gases in patients with acute pulmonary embolism (PE). Method: This retrospective study design was carried out in the Tertiary Training and Research Hospital Emergency Clinic over a 6-month period with patients in whom PE was detected. The Alveolar-arterial (A-a) oxygen gradient for oxygen was calculated according to the formula 150 - 1.25 (PaCO2 - PaO2), and the PAOI for each patient was measured with the Qanadli score at the mediastinal window using chest CT angiography (CTA). Results: There were 113 patients included in the study; their mean age was 61.40 (±16.082) years and 51.4% of the patients were female. The mean Alveolar-arterial (A-a) oxygen gradient value was 65.13(±18.78) in massive embolism group. The mean PAOI was determined as 34.027 (min:7.5, max:83.7). The relationship between the radiologically measured PAOI and the Alveolar-arterial (A-a) oxygen gradient were compared, and an increase in the index was detected as the Alveolar-arterial (A-a) oxygen gradient level increased; this difference was found to be statistically significant (r=0.400; p