Volumetric capnography: In the diagnostic work-up of chronic thromboembolic disease

Marcos Mello Moreira¹, Renato Giuseppe Giovanni Terzi¹, Laura Cortellazzi², Antonio Luis Eiras Falcão¹, Heitor Moreno Junior², Luiz Cláudio Martins², Otavio Rizzi Coelho²

¹Department of Surgery, ²Department of Internal Medicine, State University of Campinas, School of Medical Sciences, Campinas, Sao Paulo, Brazil

Abstract: The morbidity and mortality of pulmonary embolism (PE) have been found to be related to early diagnosis and appropriate treatment. The examinations used to diagnose PE are expensive and not always easily accessible. These options include noninvasive examinations, such as clinical pretests, ELISA D-dimer (DD) tests, and volumetric capnography (VCap). We report the case of a patient whose diagnosis of PE was made via pulmonary arteriography. The clinical pretest revealed a moderate probability of the patient having PE, and the DD result was negative; however, the VCap associated with arterial blood gases result was positive. The patient underwent all noninvasive exams following admission to hospital and again eight months after discharge. Results gained from invasive tests were similar to those produced by image exams, highlighting the importance of VCap as an important noninvasive tool.

Keywords: pulmonary embolism, pulmonary hypertension, volumetric capnography, d-dimers, pretest probability