title: Effect of epinephrine on end-tidal carbon dioxide monitoring during CPR.
abstract: End-tidal carbon dioxide (ETCO2) has been shown to correlate with coronary perfusion pressure (CPP) during CPR and has been proposed as a useful noninvasive monitor of CPR efficacy. The effects of therapeutic epinephrine dosing on ETCO2 and CPP in six dogs were examined. Ventricular fibrillation was induced and left untreated for five minutes before CPR was initiated. After five minutes of CPR, epinephrine 0.045 mg/kg IV was administered. CPP and ETCO2 were compared immediately before and two minutes after epinephrine administration. There was a significant increase in CPP from 12.2 +/- 9.6 to 26.8 +/- 7.1 mm Hg (P = .006) after epinephrine. This was accompanied by a significant decrease in ETCO2 from 8.2 +/- 2.9 to 3.8 +/- 2.0 mm Hg (P = .01). These data indicate that after epinephrine administration, caution must be exercised in using ETCO2 as an indicator of CPP.
authors.affiliation: Department of Emergency Medicine, Henry Ford Hospital, Detroit, Michigan 48202.
authors.forename: G B
authors.initials: GB
authors.lastname: Martin
authors.forename: N T
authors.initials: NT
authors.lastname: Gentile
authors.forename: N A
authors.initials: NA
authors.lastname: Paradis
authors.forename: J
authors.initials: J
authors.lastname: Moeggenberg
authors.forename: T J
authors.initials: TJ
authors.lastname: Appleton
authors.forename: R M
authors.initials: RM
authors.lastname: Nowak
mesh_terms: D000818:Animals; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D002245:Carbon Dioxide / Q000502:physiology; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology; D004285:Dogs; D004837:Epinephrine / Q000494:pharmacology*; D008176:Lung Volume Measurements; D008991:Monitoring, Physiologic; D012151:Resuscitation; D013990:Tidal Volume / Q000187:drug effects* / Q000502:physiology; D013997:Time Factors
chemical_list: D002245:Carbon Dioxide; D004837:Epinephrine