Evidence map›Paper›PMID 26821648›Full record

Observational studyBMC emergency medicine2016

Diagnostic value of end tidal capnography in patients with hyperglycemia in the emergency department.

Ralphe Bou Chebl, Bryan Madden, Justin Belsky, Elie Harmouche, Lenar Yessayan

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in BMC emergency medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 20% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Review
  5. 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

5 authors at 3 institutions in 2 countries.

Ralphe Bou CheblDepartment of Emergency Medicine, American University of Beirut, Beirut, Lebanon. rb94@aub.edu.lb.
Bryan MaddenDepartment of Emergency Medicine, Henry Ford Hospital, Detroit, MI, USA.
Justin BelskyDepartment of Emergency Medicine, Massachusetts General Hospital, Boston, MA, USA.
Elie HarmoucheDepartment of Emergency Medicine, Henry Ford Hospital, Detroit, MI, USA.
Lenar YessayanDivision of Nephrology and Hypertension, Henry Ford Hospital, Detroit, MI, USA.
Henry Ford Hospital · USAmerican University of Beirut · LBMassachusetts General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDiabetic Ketoacidosis (DKA) is a potentially life-threatening emergency that requires prompt diagnosis and treatment. In paediatric populations an end tidal capnography value greater than 36 mmHg was found to be 100 % sensitive in ruling out DKA.

methodsA cross sectional observational study of adults ≥ 17 years of age presenting to the emergency department between January 2014 and May 2014 with glucose > 550 mg/dL. In all patients, nasal capnography and venous blood gas analysis were performed prior to any insulin or intravenous fluid administration. The diagnosis of DKA was based on the presence of anion gap metabolic acidosis, hyperglycaemia and ketonemia. The overall diagnostic performance (area under the curve [AUC]), sensitivity, specificity and likelihood ratios at different end tidal CO2 (ETCO2) cut-offs were determined.

results71 patients were enrolled in the study of which 21 (30 %) met the diagnosis of DKA. The area under the curve for ETCO2 was 0.95 with a 95 % CI of 0.91 to 0.99. Test sensitivity for DKA at ETCO2 level ≥35 mmHg was 100 % (95 % CI, 83.9-100). An ETCO2 level ≤ 21 mmHg was 100 % specific (95 % CI, 92.9-100.0) for DKA.

conclusionNasal capnography exhibits favourable diagnostic performance in detecting patients with or without DKA among those who present to the emergency department with a glucometer reading > 550 mg/dL.

Indexed as

CapnographyEmergency Service, HospitalHyperglycemiaPredictive Value of TestsAdultCross-Sectional StudiesDiabetic KetoacidosisFemaleHumansMaleMiddle Aged

Identifiers

PMID26821648
PMCPMC4731965
OpenAlexW2255118347

What OpenQuestion holds

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Registered trials

None linked

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.