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{
    "pk": 7583,
    "title": "Predictive Value of Capnography for Suspected Diabetic Ketoacidosis in the Emergency Department",
    "subtitle": null,
    "abstract": "Introduction: \nMetabolic acidosis confirmed by arterial blood gas (ABG) analysis is one of the diagnostic criteria for diabetic ketoacidosis (DKA). Given the direct relationship between end-tidal carbon dioxide (ETco2), arterial carbon dioxide (PaCO2) and metabolic acidosis, measuring ETco2 may serve as a surrogate for ABG in the assessment of possible DKA. The current study focuses on the predictive value of capnography in diagnosing DKA in patients referring to the emergency department (ED) with increased blood sugar levels and probable diagnosis of DKA.\n \nMethods: \nIn a cross-sectional prospective descriptive-analytic study carried out in an ED, we studied 181 patients older than 18 years old with blood sugar levels of higher than 250 mg/dl and probable DKA. ABG and capnography were obtained from all patients. To determine predictive value, sensitivity, specificity and cut-off points, we developed receiver operating characteristic curves.\n \nResults: \nSixty-two of 181 patients suffered from DKA. We observed significant differences between both groups (DKA and non-DKA) regarding age, pH, blood bicarbonate, PaCO2 and ETco2 values (P≤0.001). Finally, capnography values more than 24.5 mmHg could rule out the DKA diagnosis with a sensitivity and specificity of 0.90.\n \nConclusion: \nCapnography values greater than 24.5 mmHg accurately allow the exclusion of DKA in ED patients suspected of that diagnosis. Capnography levels lower that 24.5 mmHg were unable to differentiate between DKA and other disease entities. [West J Emerg Med. 2013;14(6):590–594.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Diabetic Ketoacidosis, Arterial Blood Gas analysis, End-tidal Carbon Dioxide, Capnography"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/5qz744fv",
    "frozenauthors": [
        {
            "first_name": "Hassan",
            "middle_name": "",
            "last_name": "Soleimanpour",
            "name_suffix": "",
            "institution": "Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.",
            "department": "None"
        },
        {
            "first_name": "Ali",
            "middle_name": "",
            "last_name": "Taghizadieh",
            "name_suffix": "",
            "institution": "Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.",
            "department": "None"
        },
        {
            "first_name": "Mitra",
            "middle_name": "",
            "last_name": "Niafar",
            "name_suffix": "",
            "institution": "Bone Research Center, Endocrine Section, Imam Reza Medical Research & Training Hospital, Tabriz, Iran.",
            "department": "None"
        },
        {
            "first_name": "Farzad",
            "middle_name": "",
            "last_name": "Rahmani",
            "name_suffix": "",
            "institution": "Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.",
            "department": "None"
        },
        {
            "first_name": "Samad",
            "middle_name": "EJ",
            "last_name": "Golzari",
            "name_suffix": "",
            "institution": "1- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran\n\n2-Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.",
            "department": "None"
        },
        {
            "first_name": "Robab",
            "middle_name": "",
            "last_name": "Mehdizadeh Esfanjani",
            "name_suffix": "",
            "institution": "Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.",
            "department": "None"
        }
    ],
    "date_submitted": "2012-10-22T23:32:34Z",
    "date_accepted": "2012-10-22T23:32:34Z",
    "date_published": "2013-11-05T08:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/7583/galley/4455/download/"
        }
    ]
}