Diagnostic value of end tidal capnography in patients with hyperglycemia in the emergency department

BMC Emergency Medicine
Ralphe Bou CheblLenar Yessayan

Abstract

Diabetic Ketoacidosis (DKA) is a potentially life-threatening emergency that requires prompt diagnosis and treatment. In paediatric populations an end tidal capnography value greater than 36 mmHg was found to be 100 % sensitive in ruling out DKA. A cross sectional observational study of adults ≥ 17 years of age presenting to the emergency department between January 2014 and May 2014 with glucose > 550 mg/dL. In all patients, nasal capnography and venous blood gas analysis were performed prior to any insulin or intravenous fluid administration. The diagnosis of DKA was based on the presence of anion gap metabolic acidosis, hyperglycaemia and ketonemia. The overall diagnostic performance (area under the curve [AUC]), sensitivity, specificity and likelihood ratios at different end tidal CO2 (ETCO2) cut-offs were determined. 71 patients were enrolled in the study of which 21 (30 %) met the diagnosis of DKA. The area under the curve for ETCO2 was 0.95 with a 95 % CI of 0.91 to 0.99. Test sensitivity for DKA at ETCO2 level ≥35 mmHg was 100 % (95 % CI, 83.9-100). An ETCO2 level ≤ 21 mmHg was 100 % specific (95 % CI, 92.9-100.0) for DKA. Nasal capnography exhibits favourable diagnostic performance in detecting patients with or without ...Continue Reading

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Citations

May 10, 2020·The European Respiratory Journal·Konstantinos P ExarchosKonstantinos Kostikas
Oct 11, 2017·The Journal of Emergency Medicine·Brit LongMichael A Vivirito

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Methods Mentioned

BETA
blood draws
blood

Software Mentioned

SAS
MedCalc

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