Bedside noninvasive detection of acute pulmonary embolism in critically ill surgical patients.

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Abstract
PULMONARY embolism (PE) presents the clinician with a difficult diagnostic dilemma. Pulmonary embolism occurs relatively infrequently, in about 1% to 2% of trauma patients,1,2 and it is fatal in about 25% to 50% of these cases.1,2 Initial signs and symptoms are varied and nonspecific.3 The consequence of failing to diagnose or delaying the correct diagnosis of PE may be death. Because the treatment of PE, anticoagulation, can be associated with substantial risks and even death, overdiagnosis is similarly problematic. Unfortunately, the currently available diagnostic studies, ventilation-perfusion scan and pulmonary angiogram, are cumbersome, invasive, and expensive. The transportation of patients who required mechanical ventilation for either of these diagnostic studies is further associated with major risks. Because of these facts, a bedside noninvasive screening test that could accurately exclude the diagnosis of PE in patients without PE and identify patients with a high likelihood of PE is urgently needed.