Tags

Type your tag names separated by a space and hit enter

[Pulmonary embolism and sibilant types of chronic obstructive pulmonary disease decompensations].
Rev Mal Respir. 2002 Sep; 19(4):415-23.RM

Abstract

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.

Authors+Show Affiliations

Service de Pneumologie et Unité de Réanimation Respiratoire, Groupe Hospitalier Universitaire Sud, 80054 Amiens Cedex 1, France.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

fre

PubMed ID

12417857

Citation

Mispelaere, D, et al. "[Pulmonary Embolism and Sibilant Types of Chronic Obstructive Pulmonary Disease Decompensations]." Revue Des Maladies Respiratoires, vol. 19, no. 4, 2002, pp. 415-23.
Mispelaere D, Glerant JC, Audebert M, et al. [Pulmonary embolism and sibilant types of chronic obstructive pulmonary disease decompensations]. Rev Mal Respir. 2002;19(4):415-23.
Mispelaere, D., Glerant, J. C., Audebert, M., Remond, A., Sevestre-Pietri, M. A., & Jounieaux, V. (2002). [Pulmonary embolism and sibilant types of chronic obstructive pulmonary disease decompensations]. Revue Des Maladies Respiratoires, 19(4), 415-23.
Mispelaere D, et al. [Pulmonary Embolism and Sibilant Types of Chronic Obstructive Pulmonary Disease Decompensations]. Rev Mal Respir. 2002;19(4):415-23. PubMed PMID: 12417857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Pulmonary embolism and sibilant types of chronic obstructive pulmonary disease decompensations]. AU - Mispelaere,D, AU - Glerant,J C, AU - Audebert,M, AU - Remond,A, AU - Sevestre-Pietri,M A, AU - Jounieaux,V, PY - 2002/11/6/pubmed PY - 2002/12/10/medline PY - 2002/11/6/entrez SP - 415 EP - 23 JF - Revue des maladies respiratoires JO - Rev Mal Respir VL - 19 IS - 4 N2 - 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. SN - 0761-8425 UR - https://www.unboundmedicine.com/medline/citation/12417857/[Pulmonary_embolism_and_sibilant_types_of_chronic_obstructive_pulmonary_disease_decompensations]_ L2 - http://www.em-consulte.com/retrieve/pii/MDOI-RMR-09-2002-19-4-0761-8425-101019-ART7 DB - PRIME DP - Unbound Medicine ER -