| Pulmonary embolism and sibilant types of chronic obstructive pulmonary disease decompensations | |
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MedLine Citation:
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PMID: 12417857 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Pulmonary Embolism (PE) poses an important diagnostic problem in patients with chronic obstructive pulmonary disease (COPD). Indeed PE may aggravate the already precarious respiratory state of these fragile patients. Moreover, these two conditions share common symptoms: dyspnoea, wheezing, pleural pain, haemoptysis, palpitations and signs of right cardiac insufficiency. In two studies, one retrospective and the other prospective, we investigated the incidence of PE in patients with non-infective exacerbations of their COPD. The retrospective study was carried out over two years and involved 50 COPD patients with non-infective respiratory exacerbations. In this population, 10 patients out of 50 (20%) had a documented PE. No predictive factor was identified. The prospective study was conducted over one year and COPD patients admitted to hospital with exacerbations were included in the study if they had a positive D-dimer blood test and no evidence of acute respiratory infection. 31 patients were studied with Doppler ultra-sound examination of the legs and a lung perfusion scan. The presence or absence of PE was determined and the two groups were compared. 9 patients out of 31 (29%) had a documented PE. Six of these nine patients had a deep venous thrombosis (DVT). Two predictive factors of PE were identified: existence of a DVT and a significant fall in PaO(2) from baseline state (DeltaPaO(2) > 22 mmHg). We conclude that PE is a frequent (20 to 30%) of non-infective respiratory decompensation in COPD patients. Faced with an unexplained respiratory exacerbation in these patients, a lung perfusion scan should be routinely undertaken to rule out a PE when the D-dimers are positive. |
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Authors:
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D Mispelaere; J C Glerant; M Audebert; A Remond; M A Sevestre-Pietri; V Jounieaux |
Publication Detail:
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Type: English Abstract; Journal Article |
Journal Detail:
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Title: Revue des maladies respiratoires Volume: 19 ISSN: 0761-8425 ISO Abbreviation: Rev Mal Respir Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-11-05 Completed Date: 2002-12-09 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8408032 Medline TA: Rev Mal Respir Country: France |
Other Details:
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Languages: fre Pagination: 415-23 Citation Subset: IM |
Affiliation:
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Service de Pneumologie et Unité de Réanimation Respiratoire, Groupe Hospitalier Universitaire Sud, 80054 Amiens Cedex 1, France. |
Vernacular Title:
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Embolie pulmonaire et formes sibilantes des décompensations de bronchopneumopathie chronique obstructive. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Gas Analysis Chest Pain / etiology Dyspnea / etiology Electrocardiography Female Fibrin Fibrinogen Degradation Products / metabolism Hemoptysis / etiology Humans Incidence Male Predictive Value of Tests Prospective Studies Pulmonary Disease, Chronic Obstructive / complications* Pulmonary Embolism / blood, diagnosis, epidemiology, etiology* Respiratory Function Tests Respiratory Sounds / etiology* Retrospective Studies Risk Factors Sensitivity and Specificity Ultrasonography, Doppler Venous Thrombosis / diagnosis, epidemiology, etiology |
| Chemical | |
Reg. No./Substance:
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0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D |
| Comments/Corrections | |
Comment In:
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Rev Mal Respir. 2002 Sep;19(4):399-400
[PMID:
12417852
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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