Prognostic value of arterial/alveolar oxygen tension ratio (a/APO2) in acute pulmonary embolism

Circulation Journal : Official Journal of the Japanese Circulation Society
Jen Te HsuChang Min Chung

Abstract

Because the arterial/alveolar oxygen tension ratio (a/APO2) is relatively constant throughout the entire range of fractional inspired oxygen concentration (FiO2), its use in determining the prognosis of acute pulmonary embolism (APE) was investigated. This study retrospectively assessed 202 consecutive patients with APE confirmed by computed tomography or high probability lung scintigraphy. All patients underwent initial arterial blood gas analysis during the first 24 h of admission. Receiver-operating characteristic analyses were performed to determine the a/APO2 cut-off value for predicting 30-day death or 30-day composite events. Cut-off values for a/APO2 were used to determine stability in all patients and 2 subgroups (0.49 for all patients; 0.49 for FiO2 =0.21; 0.46 for FiO2 >0.21). Using the cut-off value of a/APO2 <0.49 for predicting 30-day death, the negative predictive value (NPV) was 90%, and the positive predictive value (PPV) was 30.3%. For the 30-day composite end point, the NPV was 81.3%, and the PPV was 40.9%. Excluding massive APE, the a/APO2 also had high NPV and moderate PPV in predicting short-term prognosis. This study additionally demonstrated a linear relationship between platelet count and a/APO2. The cu...Continue Reading

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Citations

Sep 13, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Jen Te HsuChinae Miyamoto
Dec 2, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Takeshi YamamotoKeiji Tanaka
Aug 4, 2009·Vascular Health and Risk Management·Luca MasottiPatrick Ray
Aug 21, 2009·Journal of Veterinary Emergency and Critical Care·Robert GoggsDaniel L Chan
Aug 15, 2012·Journal of Hepatology·Emmanuel MelloulJacques Belghiti

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