The gradient between arterial and end-tidal carbon dioxide predicts in-hospital mortality in post-cardiac arrest patient

We investigated the predictive value of the gradient between arterial carbon dioxide (PaCO2) and end-tidal carbon dioxide (ETCO2) (Pa-ETCO2) in post-cardiac arrest patients for in-hospital mortality. This retrospective observational study evaluated cardiac arrest patients admitted to the emergency d...

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Bibliographic Details
Published in:The American journal of emergency medicine 2019-01, Vol.37 (1), p.1-4
Main Authors: Kim, Yong Won, Hwang, Sung Oh, Kang, Hee Seung, Cha, Kyoung-Chul
Format: Article
Language:English
Subjects:
Capnography
Carbon dioxide
Cardiac arrest
Cardiopulmonary resuscitation
Conflicts of interest
CPR
Emergency medical care
Emergency medical services
Etiology
Heart
Heart arrest
Heart attacks
Medical records
Mortality
Multivariate analysis
Observational studies
Patients
Regression analysis
Ventilators
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Summary:We investigated the predictive value of the gradient between arterial carbon dioxide (PaCO2) and end-tidal carbon dioxide (ETCO2) (Pa-ETCO2) in post-cardiac arrest patients for in-hospital mortality. This retrospective observational study evaluated cardiac arrest patients admitted to the emergency department of a tertiary university hospital. The PaCO2 and ETCO2 values at 6, 12, and 24 h after return of spontaneous circulation (ROSC) were obtained from medical records and Pa-ETCO2 gap was calculated as the difference between PaCO2 and ETCO2 at each time point. Multivariate logistic regression analysis was performed to verify the relationship between Pa-ETCO2 gap and clinical variables. Receiver operating characteristic (ROC) curve analysis was performed to determine the cutoff value of Pa-ETCO2 for predicting in-hospital mortality. The final analysis included 58 patients. In univariate analysis, Pa-ETCO2 gaps were significantly lower in survivors than in non-survivors at 12 h [12.2 (6.5–14.8) vs. 13.9 (12.1–19.6) mmHg, p = 0.040] and 24 h [9.1 (6.3–10.5) vs. 17.1 (13.1–23.2) mmHg, p 
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2018.04.025