Document Detail

Detection of pulmonary emboli after total hip replacement using serial C15O2 pulmonary scans.
MedLine Citation:
PMID:  6438108     Owner:  NLM     Status:  MEDLINE    
15-O-labeled carbon dioxide (C15O2) was used for the detection of preoperative and postoperative pulmonary emboli in seventy-three patients, more than forty years old, who had undergone a total hip replacement. When the C15O2 scan was suggestive of pulmonary embolism, it was followed by conventional perfusion and ventilation (V/Q) scans. If these also suggested the presence of embolism, pulmonary angiography was done. Three different prophylactic agents against venous thromboembolic disease had been used in the seventy-three patients. Seventeen (23 per cent) of the seventy-three patients had a positive C15O2 pulmonary scan followed by a positive ventilation-perfusion scan and a positive pulmonary angiogram that showed pulmonary emboli. Fourteen (83 per cent) of these patients with proved pulmonary emboli were asymptomatic. Fifteen additional patients also had a positive C15O2 scan. However, twelve of them had either negative ventilation-perfusion scans or chest radiographs that demonstrated atelectasis, and did not have a pulmonary angiogram. Three patients with a positive C15O2 scan had a negative pulmonary angiogram. Two of them had a ventilation-perfusion scan that was interpreted as showing probable pulmonary emboli, and the remaining patient did not have a ventilation-perfusion scan. Forty-six per cent of the patients with positive C15O2 scans did not have pulmonary emboli. This sensitive and readily repeatable test provides an excellent means of detection of silent emboli, an improved method of evaluating the efficacy of prophylactic agents, and the opportunity to correlate the site, size, and onset of deep-vein thrombosis with pulmonary emboli in vivo.(ABSTRACT TRUNCATED AT 250 WORDS)
W H Harris; K McKusick; C A Athanasoulis; A C Waltman; H W Strauss
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  66     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  1984 Dec 
Date Detail:
Created Date:  1985-01-23     Completed Date:  1985-01-23     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1388-93     Citation Subset:  AIM; IM    
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MeSH Terms
Carbon Dioxide / diagnostic use*
Fibrinogen / diagnostic use
Hip Prosthesis*
Middle Aged
Oxygen Radioisotopes / diagnostic use
Postoperative Complications / diagnosis
Pulmonary Embolism / diagnosis,  radionuclide imaging*
Thromboembolism / diagnosis,  prevention & control
Ventilation-Perfusion Ratio
Grant Support
Reg. No./Substance:
0/Oxygen Radioisotopes; 124-38-9/Carbon Dioxide; 9001-32-5/Fibrinogen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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