Medicina Translacional
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Using End-Tidal CO2 Measurement as a Tool to Diagnose Pulmonary Embolism

Badie Jacob, Fanila Shahzad, Hassan Ugail, Jonathan Walker, Andrew Scally, Mojgan Najafzadeh

Pulmonary Embolism (PE) is a serious medical condition that presents diagnostic challenges due to its non-specific signs and symptoms. In the pathophysiology of PE, pulmonary vascular artery obstructions can cause a range of symptoms, from mild to severe, depending on the size and location of the obstruction. Unfortunately, current diagnostic tests for PE, such as Computed Tomography Pulmonary Angiogram (CTPA) and plasma D-dimer measurement, are inefficient and costly. However, hypoxia and hypocapnia are two hallmark signs of PE, which manifest as decreased oxygen levels and increased carbon dioxide levels, respectively. Therefore, measuring End-Tidal CO₂ (ETCO₂) levels, which indicate the level of Carbon Dioxide (CO₂) in expiration, is a feasible and straightforward method for diagnosing PE.

We conducted a study with 479 patients to investigate the relationship between ETCO₂, D-dimer and CTPA. Our findings suggest that ETCO₂ measurement is sensitive enough to exclude PE in approximately 82% of cases. Based on this data, we propose a machine-learning tool for predicting PE using ETCO₂ measurements. This tool has the potential to be developed into an automated diagnostic aid for PE. In conclusion, our study highlights the potential of ETCO₂ measurement as a diagnostic tool for PE. With further development and refinement, an automated diagnostic tool using ETCO₂ measurements could provide a more efficient and cost-effective means of diagnosing PE, which would benefit patients and healthcare providers alike.