End-tidal carbon dioxide during out-of-hospital cardiac arrest resuscitation: comparison of active compression-decompression and standard CPR.
OBJECTIVE
To compare the maximal end-tidal carbon dioxide pressure (ETCO2 peak) values obtained during standard (S-CPR) and active compression-decompression CPR (ACD-CPR) during prolonged resuscitation in out-of-hospital cardiac arrest.


METHODS
Prospective, randomized crossover study.


METHODS
City with a population of 3.5 million, served by an emergency medical service system providing advanced cardiac life support.


METHODS
Patients with nontraumatic out-of-hospital cardiac arrest.


METHODS
Patients were randomly assigned to receive first, for a period of 3 minutes, either ACD-CPR or S-CPR; then the two methods were alternated. ETCO2 was continuously monitored and computed.


RESULTS
Sixteen patients (48 +/- 20 years old) were included; in 12, return of spontaneous circulation was achieved, and 5 were admitted alive to the hospital. A statistically significant increase in ETCO2 peak was obtained with ACD-CPR (27.6 +/- 3 mm Hg) compared with S-CPR (15.6 +/- 2.2 mm Hg). No major adverse effect possibly related to ACD-CPR was observed.


CONCLUSIONS
This prospective study suggests that ACD-CPR may improve cardiac output compared with S-CPR.
Orliaguet
G A
GA
Service d'Aide Médicale Urgente (SAMU) de Paris, Department of Anesthesiology, Hôpital Necker.
Carli
P A
PA
Rozenberg
A
A
Janniere
D
D
Sauval
P
P
Delpech
P
P
D000328:Adult; D000368:Aged; D002245:Carbon Dioxide; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D018592:Cross-Over Studies; D004632:Emergency Medical Services; D005260:Female; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012119:Respiration; D013990:Tidal Volume
D002245:Carbon Dioxide