Sequential D-Dimer Measurements Can Reveal Asymptomatic Pulmonary Embolism in Patients With Burn Injuries

Abstract

Venous thromboembolism is diagnosed by clinical and imaging findings. Another possible test is measurement of D-dimers in the blood; high levels can signal endogenous fibrinolysis. The D-dimer test is a highly sensitive test for excluding venous thromboembolism but has low specificity. Consequently, its utility in patients with burn injuries has been questioned. Here, we describe the case of a patient with bilateral lower leg burns and skin grafting surgery who developed a pulmonary embolism despite prophylactic heparin administration. We discuss the diagnosis of this case and how the embolism could have been prevented.