Evidence map›Paper›PMID 19399946›Full record

ArticleCroatian medical journal2009

Combination of quantitative capnometry, N-terminal pro-brain natriuretic peptide, and clinical assessment in differentiating acute heart failure from pulmonary disease as cause of acute dyspnea in pre-hospital emergency setting: study of diagnostic accuracy.

Petra Klemen, Mirjam Golub, Stefek Grmec

Registry-linked trialOpen access · diamondAbstract readComparative Study
In one paragraph

Article in Croatian medical journal, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01235182 (Combination of Lung Ultrasound), which is not on this map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 pooled it
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01235182 completednot on this map

Combination of Lung Ultrasound(a Comet-tail Sign) and N-terminal Pro-brain Natriuretic Paptide in Differentiating Acute Dyspnea in Prehospital Emergency Setting

TypeobservationalSponsorUniversity Medical Centre MariborRan2007 to 2010Enrolled248ConditionsHeart Failure, COPD, Asthma
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Observational
  6. Review
  7. Article
  8. [Point-of-care testing in preclinical emergency medicine].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2014
    Review
  9. End-tidal carbon dioxide monitoring during bag valve ventilation: the use of a new portable device.Scandinavian journal of trauma, resuscitation and emergency medicine · 2010
    Article
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Petra KlemenCenter for Emergency Medicine, Ulica talcev 9, 2000 Maribor, Slovenia.
Mirjam Golub
Stefek Grmec
Izobraževalni Center Piramida Maribor · SIUniversity of Maribor · SI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo determine the diagnostic accuracy of the combination of quantitative capnometry (QC), N-terminal pro-brain natriuretic peptide (NT-proBNP), and clinical assessment in differentiating heart failure (HF)-related acute dyspnea from pulmonary-related acute dyspnea in a pre-hospital setting.

methodsThis prospective study was performed in the Center for Emergency Medicine Maribor, Slovenia, January 2005-June 2007. Two groups of patients with acute dyspnea apnea were compared: HF-related acute dyspnea group (n = 238) vs pulmonary-related acute dyspnea (asthma/COPD) group (n = 203). The primary outcome was the comparison of combination of QC, NT-proBNP, and clinical assessment vs NT-proBNP alone or NT-proBNP in combination with clinical assessment, in differentiating HF-related acute dyspnea from pulmonary-related acute dyspnea (asthma/COPD) in pre-hospital emergency setting, using the area under the receiver operating characteristic curve (AUROC). The secondary outcomes end points were identification of independent predictors for final diagnosis of acute dyspnea (caused by acute HF or pulmonary diseases), and determination of NT-proBNP levels, as well as capnometry, in the subgroup of patients with a previous history of HF and in the subgroup of patients with a previous history of pulmonary disease.

resultsIn differentiating between cardiac and respiratory causes of acute dyspnea in pre-hospital emergency setting, NT-proBNP in combination with PetCO2 and clinical assessment (AUROC, 0.97; 95% confidence interval [CI], 0.90-0.99) was superior to combination of NT-proBNP and clinical assessment (AUROC, 0.94; 95% CI, 0.88-0.96; P = 0.006) or NT-proBNP alone (AUROC, 0.90; 95% CI, 0.85-0.94; P = 0.005). The values of NT-proBNP> or = 2000 pg/mL and PetCO2 < or = 4 kPa were strong independent predictors for acute HF. In the group of acute HF dyspneic patients, subgroup of patients with previous COPD/asthma had significantly higher PetCO2 (3.8 +/- 1.2 vs 5.8 +/- 1.3 kPa, P = 0.009). In the group of COPD/asthma dyspneic patients, NT-proBNP was significantly higher in the subgroup of patients with previous HF (1453.3 +/- 552.3 vs 741.5 +/- 435.5 pg/mL, P = 0.010).

conclusionIn differentiating between cardiac and respiratory causes of acute dyspnea in pre-hospital emergency setting, NT-proBNP in combination with capnometry and clinical assessment was superior to NT-proBNP alone or NT-proBNP in combination with clinical assessment.

Indexed as

Acute DiseaseAnalysis of VarianceCapnographyCohort StudiesConfidence IntervalsDiagnosis, DifferentialDyspneaEmergenciesEmergency Medical ServicesFemaleHeart FailureHumansLung DiseasesMaleNatriuretic Peptide, BrainOdds RatioNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)

Identifiers

PMID19399946
PMCPMC2681050
OpenAlexW2074932603

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.