Acute pulmonary embolism: epidemiologic and tomodensitometric study

Acute pulmonary embolism is a common disease with substantial morbidity and mortality in untreated patients. It requires an urgent positive diagnosis. To assess the prevalence of acute pulmonary embolism and calculate the sensitivity and specificity of multidetector CT for the diagnosis of acute pulmonary embolism in a hospital specialized in cardio-thoracic diseases. This is a prospective study conducted at Abderrahmen Mami Hospital, which included 200 consecutive patients suspected of acute pulmonary embolism and explored by a multidetector CT pulmonary angiography [16 slices]. Prevalence of acute pulmonary embolism was calculated at 37.5%. The multidetector CT has enabled an alternative diagnosis in 46 patients [40%]. The sensitivity and specificity of multidetector CT were calculated respectively 89.6% and 100%. The prevalence of acute pulmonary embolism, in a hospital specialized in cardio-thoracic diseases, is higher than that found in general hospitals. High sensitivity and specificity of multidetector CT makes it the gold standard for the diagnosis of pulmonary embolism

[Mechanical ventilation in intensive care units: indications, modalities and complications. A prospective multicentric survey in Tunisia]

The survey was perfomed during the month of march 1998 and concerned 9 ICUs located in teraching hospitals. Tp be included each ICU had to MV for more than 12 hours were included in the study and had a 28 day follow-up in the ICU or until hospital discharge. Collected parameters were indications of MV, modalities of MV and of weaning, complication and outcome at ospoital discharge. Assist-control ventilation was the most used ventilation modality [69,8%]. Weaning of MV was performed in 63% of the study patients and was based on a once-a-day attempt of spontaneous breathing through a T-piece [59,5%] and a combination of intermittent mandatory ventilation with pressure support [IMV-PS: 27%] or pressure support alone [11,2%]. Mean lenght of hospital stay was 19,7 +/- 15,9 days of which 11,6 days were spent in the ICU. Fifty nine pateints [54%] were alive at discharge form the ICU of whom 4 ultimately died during their hospital stay. MV pratice as well as ICU facilities are not homogenous in Tunisia. Recommendations and guidelines should be buil in order to standardize MV practice in Tunisia