The TL,NO/TL,CO ratio cannot be used to exclude pulmonary embolism

Timon M. Fabius, Michiel M. Eijsvogel, Ivo van der Lee, Marjolein Brusse-Keizer, Frans H. de Jongh

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)

Abstract

Background: The existing screening modalities for pulmonary embolism (PE), such as D-dimer and clinical prediction rules, have low positive predictive values. With its capability to indicate pulmonary vascular abnormalities, the ratio of the transfer factor of the lungs for nitric oxide and the transfer factor of the lungs for carbon monoxide (TL,NO/TL,CO) might be an additional discriminating parameter.
Methods: Carbon monoxide/Nitric oxide diffusion measurements were performed on unselected patients seen on the emergency department for which due to suspected PE a computed tomography pulmonary angiogram (CTPA) was ordered.
Results: A total of 28 patients were included, PE was found in 12 on CTPA. Median TL,NO/TL,CO ratio was 4·09 (interquartile range (IQR) 3·83–4·40) in the no PE group versus 4·00 (IQR 3·78–4·32) in the PE group (P = 0·959). Median alveolar volume was 77·1% of predicted in the no PE group versus 71·0% of predicted in the PE group (P = 0·353). Median TL,CO was 75·8% of predicted in the no PE group versus 68·8% of predicted in the PE group (P = 0·120). Median TL,NO was 69·3% of predicted in the no PE group versus 60·5% of predicted in the PE group (P = 0·078).
Conclusion: The presented data indicate that the TL,NO/TL,CO ratio cannot be used to exclude PE.
Original languageEnglish
Pages (from-to)400-404
JournalClinical physiology and functional imaging
Volume37
Issue number4
DOIs
Publication statusPublished - 17 Nov 2016

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