Utilizing End-Tidal Carbon Dioxide to Diagnose Diabetic Ketoacidosis in Prehospital Patients with Hyperglycemia
| Autor: | Christian Zuver, Monty Putman, Alexa Rodriguez, Linda Papa, Amy Souers, Jermaine Foster, Christopher Hunter |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Blood Glucose Male medicine.medical_specialty Emergency Medical Services Diabetic ketoacidosis Adolescent Vital signs Anion gap Emergency Nursing law.invention Diabetic Ketoacidosis Cohort Studies 03 medical and health sciences Young Adult 0302 clinical medicine law Predictive Value of Tests Internal medicine medicine Tidal Volume Humans 030212 general & internal medicine Retrospective Studies business.industry 030208 emergency & critical care medicine Metabolic acidosis Retrospective cohort study Emergency department Carbon Dioxide medicine.disease Intensive care unit Blood pressure Breath Tests Hyperglycemia Emergency Medicine Female business |
| Zdroj: | Prehospital and disaster medicine. 35(3) |
| ISSN: | 1945-1938 1049-023X |
| Popis: | Background:Early identification of diabetic ketoacidosis (DKA) may improve clinical outcomes. Prior studies suggest exhaled end tidal carbon dioxide (ETCO2) provides a non-invasive, real-time method to screen for DKA in the emergency department (ED).Methods:This a retrospective cohort study among patients who activated Emergency Medical Services (EMS) during a one-year period. Initial out-of-hospital vital signs documented by EMS personnel, including ETCO2 and first recorded blood glucose level (BGL), as well as in-hospital records, including laboratory values and diagnosis, were collected. The main outcome was the association between ETCO2 and the diagnosis of DKA.Results:Of the 118 patients transported with hyperglycemia (defined by BGL >200), six (5%) were diagnosed with DKA. The mean level of ETCO2 in those without DKA was 35mmHg (95% CI, 33-38mmHg) compared to mean levels of 15mmHg (95% CI, 8-21mmHg) in those with DKA (P Conclusion:Among patients with hyperglycemia, prehospital levels of ETCO2 were significantly lower in patients with DKA compared to those without and were predictive of the diagnosis of DKA. Furthermore, out-of-hospital ETCO2 was significantly correlated with measures of metabolic acidosis. |
| Databáze: | OpenAIRE |
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