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End-tidal carbon dioxide monitoring during cardiopulmonary resuscitation. A prognostic indicator for survival
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1989
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Adult Cardiac SurgeryCardiopulmonary ResuscitationCarbon Dioxide ExcretionCardiopulmonary Resuscitation EffortsEmergency Medicine InjuryMedicinePatient SafetyArtificial RespirationMm HgPerioperative MonitoringRespiration (Physiology)Resuscitation TrainingA Prognostic IndicatorPrehospital ResuscitationCardiologyEmergency MedicineCardiothoracic SurgeryCardiac Arrest
Evaluating CPR effectiveness is difficult, but recent studies suggest that carbon dioxide excretion may serve as a noninvasive indicator of resuscitation success. The study aimed to determine whether end‑tidal CO₂ monitoring during CPR could predict resuscitation and survival. Capnometry was performed on 35 cardiac arrest cases over one year to record end‑tidal CO₂ during CPR. Higher average end‑tidal CO₂ during CPR (≥10 mm Hg) correlated with successful resuscitation and survival, with resuscitated patients averaging 15 ± 4 mm Hg versus 7 ± 5 mm Hg for non‑resuscitated, and survivors averaging 17 ± 6 mm Hg versus 8 ± 5 mm Hg for nonsurvivors. JAMA 1989;262:1347‑1351.
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. (<i>JAMA</i>. 1989;262:1347-1351)