End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. A prognostic indicator for survival.
The effectiveness of ongoing cardiopulmonary resuscitation efforts is difficult to evaluate. Recent studies suggest that carbon dioxide excretion may be a useful noninvasive indicator of resuscitation from cardiac arrest. A prospective clinical study was done to determine whether end-tidal carbon dioxide monitoring during cardiopulmonary resuscitation could be used as a prognostic indicator of resuscitation and survival. Thirty-five cardiac arrests in 34 patients were monitored with capnometry during cardiopulmonary resuscitation during a 1-year period. Nine patients who were successfully resuscitated had higher average end-tidal carbon dioxide partial pressures during cardiopulmonary resuscitation than 26 patients who could not be resuscitated (15 +/- 4 vs 7 +/- 5 mm Hg). The 3 patients who survived to leave the hospital had a higher average end-tidal carbon dioxide partial pressure than the 32 nonsurvivors (17 +/- 6 vs 8 +/- 5 mm Hg). All 9 patients who were successfully resuscitated had an average end-tidal carbon dioxide partial pressure of 10 mm Hg or greater. No patient with an average end-tidal carbon dioxide partial pressure of less than 10 mm Hg was resuscitated. Data from this prospective clinical trial indicate that findings from end-tidal carbon dioxide monitoring during cardiopulmonary resuscitation are correlated with resuscitation from and survival of cardiac arrest.
Sanders
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Section of Emergency Medicine, University of Arizona Health Sciences Center, Tucson 85724.
Kern
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KB
Otto
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Milander
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MM
Ewy
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GA
D001785:Blood Gas Monitoring, Transcutaneous; D006323:Heart Arrest / Q000097:blood / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D008991:Monitoring, Physiologic / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial; D012151:Resuscitation / Q000379:methods*; D013997:Time Factors