title: End-tidal carbon dioxide measurements as a prognostic indicator of outcome in cardiac arrest.
abstract: OBJECTIVE
  To evaluate the use of end-tidal carbon dioxide values in predicting survival in cardiopulmonary arrest.
  
  
  BACKGROUND
  The decision about when to terminate resuscitative efforts for patients with cardiopulmonary arrest is often subjective. End-tidal carbon dioxide values have been suggested as potential objective criteriafor making this decision.
  
  
  METHODS
  This study was a cooperative effort of the St Louis chapter of the American Association of Critical-Care Nurses and its members and involved 6 hospitals and an air evacuation service. All adult patients who had a cardiopulmonary arrest were eligiblefor the study. Once a patient with cardiac arrest was intubated, end-tidal carbon dioxide and cardiac rhythms were measured and recorded every 5 minutes for 20 minutes or until resuscitation efforts were terminated. Patients' survival at the time of the arrest, survival 24 hours after the arrest, and discharge status were followed up.
  
  
  RESULTS
  A total of 127 patients were enrolled in the study. All but 1 patient with end-tidal carbon dioxide values less than 10 mm Hg died before discharge. End-tidal carbon dioxide values greater than 10 mm Hg were associated with various degrees of survival. Overall survival to discharge was less than 14%, regardless of the end-tidal carbon dioxide value.
  
  
  CONCLUSIONS
  Measurements of end-tidal carbon dioxide can be used to accurately predict nonsurvival of patients with cardiopulmonary arrest. End-tidal carbon dioxide levels should be monitored during cardiopulmonary arrest and should be considered a useful prognostic value for determining the outcome of resuscitative efforts.
authors.affiliation: Barnes-Jewish Hospital, St. Louis, MO, USA.
authors.forename: T
authors.initials: T
authors.lastname: Ahrens
authors.forename: L
authors.initials: L
authors.lastname: Schallom
authors.forename: K
authors.initials: K
authors.lastname: Bettorf
authors.forename: S
authors.initials: S
authors.lastname: Ellner
authors.forename: G
authors.initials: G
authors.lastname: Hurt
authors.forename: V
authors.initials: V
authors.lastname: O'Mara
authors.forename: J
authors.initials: J
authors.lastname: Ludwig
authors.forename: W
authors.initials: W
authors.lastname: George
authors.forename: T
authors.initials: T
authors.lastname: Marino
authors.forename: W
authors.initials: W
authors.lastname: Shannon
mesh_terms: D019296:Capnography; D002245:Carbon Dioxide / Q000032:analysis*; D016887:Cardiopulmonary Resuscitation; D006323:Heart Arrest / Q000401:mortality / Q000503:physiopathology*; D006801:Humans; D011379:Prognosis; D013990:Tidal Volume; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide