Abstract

In this study, we aimed to determine the effect of the anatomic severity of pulmonary thromboembolism (PTE) on its clinical presentation and relation with the impairment of gas exchange. 121 patients with PTE (65 female, 56 male, mean age 58±15.1 years) were included in the study. In order to assess the severity of PTE, pulmonary vascular obstruction scores (PVOs) from the perfusion scintigraphies of the patients were calculated. Patients with PVOs >50% were compared to those with PVOs <50% in terms of clinical parameters, risk factors and arterial blood gas (ABG) analysis. 70 patients had PVOs <50% (mean 36.6±8.3%) and 51 had PVOs >50% (mean 62.2±9.4%). Both groups had nearly the same number of risk factors. When evaluated in terms of symptoms; chest pain occured more frequently in the group with PVOs <50%, and dyspnea in the PVOs >50% group. There was no significant difference between the groups when they were compared according to their other symptoms, respiration rate, pulse rate and blood pressures. Patients with PVOs >50% had significantly worse arterial blood gas parameters than those with PVOs <50% [PaO2, PaCO2, Pa(A-a)O2 (mmHg) and SO2(%) were 59.3±9.9, 30.4±7, 52.5±12.0, 90.4±5.5 and 66.3±10.4, 33.9±5.5, 41.2±12.4, 92.8±2.8, p<0.01 in patients with PVOs >50% and <50% respectively]. As all the patients were taken into consideration it was seen that when PVOs increased; PaO2 decreased (r=-0.395, p<0.001) and Pa(A-a)O2 increased (r=0.455, p<0.001). In conclusion because of the anatomic severity of PTE impairs the gas exchange, its effects on the ABG values are more clear than the clinical presentation of the disease. ABG analysis -yet with limited diagnostic value is an important marker to determine the severity and the anatomical spread of PTE for patients with confirmed diagnose.