{
  "abstract": "Background: Pulmonary embolism (PE) is a life-threatening emergency associated with acute cardiopulmonary deterioration. This study evaluated the clinical utility of end-tidal carbon dioxide (EtCO₂) for assessing disease severity and monitoring treatment response in high- and intermediate–high-risk PE.\n\nMethods: This prospective study (registry ID: NCT07241130) included 120 individuals presenting between February and July 2025, categorized into four groups: high-risk PE with thrombolysis, intermediate–high-risk PE with thrombolysis, intermediate–high-risk PE without thrombolysis, and healthy controls. Physiological parameters were measured using the Rad-97 monitor under standardized conditions.\n\nResults: Baseline EtCO₂ levels differed significantly among the groups (p < 0.001). The lowest mean EtCO₂ value was observed in the high-risk PE group (15.2 ± 1.9 mmHg) and the highest in the control group (31.8 ± 3.1 mmHg). After 24 h of treatment, there were no significant differences among the groups in terms of EtCO₂, peripheral oxygen saturation (SpO₂), or perfusion index (PI) values (p > 0.05). EtCO₂ was negatively correlated with pulmonary artery obstruction index (r = − 0.358, p = 0.01) and positively correlated with SpO₂ (r = 0.594, p < 0.001) and PI (r = 0.431, p < 0.001). ROC analysis identified an optimum EtCO₂ cutoff of 17.5 mmHg to discriminate between patients with and without thrombolytic therapy (97% sensitivity, 85% specificity).\n\nConclusion: EtCO₂ is a simple, noninvasive physiological marker associated with thrombus burden and treatment-related changes in PE. Rather than determining therapeutic decisions, EtCO₂ may complement established clinical and imaging parameters by providing supportive physiological information in acute settings.\n\nClinical trial number: ClinicalTrials.gov Identifier: NCT07241130. Retrospectively registered.\n\nSupplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s12890-026-04570-y.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Pulmonary Diseases, Ataturk University School of Medicine, Yakutiye, Erzurum, 25240 Turkey",
    "Department of Pulmonary Diseases, Aksaray University School of Medicine, Aksaray, Turkey",
    "Department of Radiology, Ataturk University School of Medicine, Yakutiye, Erzurum, 25240 Turkey"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Kadir Çelik"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Buğra Kerget"
    },
    {
      "affs": [
        0
      ],
      "name": "Alperen Aksakal",
      "orcid": "0000-0001-6883-3314"
    },
    {
      "affs": [
        0
      ],
      "name": "Elif Yılmazel Uçar"
    },
    {
      "affs": [
        2
      ],
      "name": "Mustafa Yeşilyurt"
    },
    {
      "affs": [
        0
      ],
      "name": "Leyla Sağlam"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/6knfgtaxf035q.bib",
  "cited_by": 0,
  "doi": "10.1186/s12890-026-04570-y",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13733090/",
  "id": "6knfgtaxf035q",
  "issns": [
    "1471-2466"
  ],
  "landing_url": "https://doi.org/10.1186/s12890-026-04570-y",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2724|Venous Thromboembolism Diagnosis and Management"
    ]
  ],
  "openalex": "W7197003520",
  "pdf_url": null,
  "pmcid": "PMC13733090",
  "pmid": "42983376",
  "published": "2026-08-07",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/6knfgtaxf035q.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:22:57Z",
      "native_id": "PMC13733090",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12890-026-04570-y"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2724|Venous Thromboembolism Diagnosis and Management",
      "subfield": "general"
    }
  ],
  "title": "Assessment of end-tidal CO₂ levels in the diagnosis and management of patients with pulmonary embolism",
  "title_text": "Assessment of end-tidal CO₂ levels in the diagnosis and management of patients with pulmonary embolism",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:22:57Z",
  "url": "https://research.draconitic.com/paper/6knfgtaxf035q",
  "venue": "BMC Pulmonary Medicine",
  "versions": []
}