The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Philip S Wells - One of the best experts on this subject based on the ideXlab platform.
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diagnostic value of Arterial Blood Gas measurement in suspected pulmonary embolism
American Journal of Respiratory and Critical Care Medicine, 2000Co-Authors: Marc A Rodger, Marc Carrier, Gwynne Jones, Pasteur Rasuli, Francois Raymond, Helene Djunaedi, Philip S WellsAbstract:Pulmonary embolism (PE) is a common and lethal yet treatable condition. Several authors have reported on the diagnostic value of combinations of Arterial Blood Gas (ABG) and other clinical data (i. e., prediction rules), and have claimed that these combinations can be safely used to exclude PE. The purpose of this investigation was to evaluate the diagnostic value of ABG measurement and to attempt to validate the ABG prediction rules published by these various authors for the assessment of patients with suspected PE. Two hundred ninety-three consecutive patients referred for imaging to investigate suspected PE were approached to participate in the investigation. ABG and other clinical data were obtained from consenting and eligible patients before an outcome classification (PE versus non-PE) was performed. None of the ABG data or prediction rules had sufficient negative predictive value, specificity, or likelihood ratios to be useful in the management of patients with suspected PE. We conclude that ABG data alone or in combination with other clinical data are not useful in the assessment of suspected PE.
Martin A Schreiber - One of the best experts on this subject based on the ideXlab platform.
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correlation of central venous and Arterial Blood Gas measurements in mechanically ventilated trauma patients
Archives of Surgery, 2005Co-Authors: Darren Malinoski, Samuel R Todd, Sue D Slone, Richard J Mullins, Martin A SchreiberAbstract:Hypothesis Central venous Blood Gas (VBG) measurements of pH, PCO 2 , and base excess can be substituted for the same values obtained from an Arterial Blood Gas (ABG) analysis in mechanically ventilated trauma patients, obviating the need for Arterial puncture. Design and Setting Prospective comparison of 99 sets of VBGs and ABGs at a level 1 academic trauma center. Patients A consecutive sample of 25 trauma patients admitted to the intensive care unit who required mechanical ventilation and had both central venous and Arterial catheters. Main Outcome Measures Pearson correlations and Bland-Altman limits of agreement (LOAs) for pH, PCO 2 , and base excess values from each set of VBGs and ABGs. Results When VBG and ABG values were compared, pH had R = 0.92, P 2 , R = 0.88, P R = 0.96, P 2 of 50 mm Hg had 100% sensitivity and 84% specificity for determining significant hypercarbia (Arterial PCO 2 > 50 mm Hg). Conclusions Central venous and Arterial PCO 2 , pH, and base excess values correlate well, but their LOAs represent clinically significant ranges that could affect management. Although VBGs cannot be substituted for ABGs in mechanically ventilated trauma patients during the initial phases of resuscitation, clinically reliable conclusions can be reached with VBG analysis.
Andrew C Miller - One of the best experts on this subject based on the ideXlab platform.
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Arterial Blood Gas analysis in the assessment of suspected acute pulmonary embolism
Chest, 1996Co-Authors: Paul D Stein, Samuel Z Goldhaber, Jerald W Henry, Andrew C MillerAbstract:Purpose The utility of Arterial Blood Gas levels in excluding the diagnosis of acute pulmonary embolism (PE) was evaluated. Methods Data are from the Prospective Investigation of Pulmonary Embolism Diagnosis (PIOPED). PE was diagnosed or excluded by pulmonary angiography. Among 330 patients with no prior cardiopulmonary disease, 130 patients had PE and 200 did not. Among 438 patients with prior cardiopulmonary disease, 147 had PE and 291 did not. Definitions were low PaO 2 ( 2 ( 2 [>20 mm Hg]). Results Among patients with no prior cardiopulmonary disease who had values of the PaO 2 and PaCO 2 that were not low and a P(A-a)O 2 that was normal, 16 of 42 or 38% (95% confidence interval [CI]=24 to 54%) had PE. Among patients with prior cardiopulmonary disease who had PaO 2 and PaCO 2 values that were not low and a P(A-a)O 2 that was normal, 4 of 28 or 14% (95% CI=4 to 33%) had PE. Other combinations of Blood Gas levels and the P(A-a)O 2 gradient, failed to exclude PE in larger percentages of patients. Conclusion With various combinations of the PaO 2 of 80 mm Hg or more, the PaCO 2 of 35 mm Hg or higher, and the P(A-a)O 2 gradient of 20 mm Hg or less, PE could not be excluded in more than 30% of patients with no prior cardiopulmonary disease and PE could not be excluded in more than 14% of patients with prior cardiopulmonary disease. Blood Gas levels, therefore, are of insufficient discriminant value to permit exclusion of the diagnosis of PE.
B. D. W. Harrison - One of the best experts on this subject based on the ideXlab platform.
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Arterial Blood Gas analysis or oxygen saturation in the assessment of acute asthma
Thorax, 1995Co-Authors: D. M. Carruthers, B. D. W. HarrisonAbstract:BACKGROUND--A study was undertaken to determine if Arterial Blood Gas estimation is always necessary in the assessment of patients presenting to hospital with acute severe asthma, or whether oxygen saturation as measured by pulse oximetry is a reliable screening test for predicting those in respiratory failure. METHODS--A prospective study was conducted in a specialist respiratory medical unit. Arterial Blood Gas tensions and pulse oximetry were measured in 89 consecutive patients admitted with acute severe asthma. Respiratory failure was defined as PaO2 6 kPa. RESULTS--When oxygen saturation was 92% or higher (72 patients) respiratory failure was found in three (4.2%) cases. In the 82 patients with a saturation of 90% or higher six patients (7.3%) had respiratory failure. CONCLUSIONS--In the initial assessment of acute severe asthma an oxygen saturation of > 92% suggests that respiratory failure is unlikely and therefore Arterial Blood Gas measurement is unnecessary. This study is only relevant to the assessment of asthmatic patients at presentation. Other parameters of severity must be continually assessed in all asthmatic patients admitted to hospital irrespective of the initial SaO2, and Blood Gases measured when clinically indicated.
Marc A Rodger - One of the best experts on this subject based on the ideXlab platform.
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diagnostic value of Arterial Blood Gas measurement in suspected pulmonary embolism
American Journal of Respiratory and Critical Care Medicine, 2000Co-Authors: Marc A Rodger, Marc Carrier, Gwynne Jones, Pasteur Rasuli, Francois Raymond, Helene Djunaedi, Philip S WellsAbstract:Pulmonary embolism (PE) is a common and lethal yet treatable condition. Several authors have reported on the diagnostic value of combinations of Arterial Blood Gas (ABG) and other clinical data (i. e., prediction rules), and have claimed that these combinations can be safely used to exclude PE. The purpose of this investigation was to evaluate the diagnostic value of ABG measurement and to attempt to validate the ABG prediction rules published by these various authors for the assessment of patients with suspected PE. Two hundred ninety-three consecutive patients referred for imaging to investigate suspected PE were approached to participate in the investigation. ABG and other clinical data were obtained from consenting and eligible patients before an outcome classification (PE versus non-PE) was performed. None of the ABG data or prediction rules had sufficient negative predictive value, specificity, or likelihood ratios to be useful in the management of patients with suspected PE. We conclude that ABG data alone or in combination with other clinical data are not useful in the assessment of suspected PE.