Carbon dioxide levels during pre-hospital active compression–decompression versus standard cardiopulmonary resuscitation

In a prospective randomised study we investigated end-tidal carbon dioxide levels during standard versus active compression–decompression (ACD) cardiopulmonary resuscitation (CPR) assuming that the end-tital carbon dioxide reflects cardiac output during resuscitation. In each group 60 patients with...

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Bibliographic Details
Published in:Resuscitation 1998-10, Vol.39 (1), p.67-74
Main Authors: Mauer, Dietmar, Schneider, Thomas, Elich, Dirk, Dick, Wolfgang
Format: Article
Language:English
Subjects:
Active compression–decompression
Aged
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Capnometry
Carbon Dioxide - analysis
Cardiac Output
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - methods
Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care
Emergency Medical Services
End-tidal carbon dioxide
Heart Arrest - mortality
Heart Arrest - therapy
Humans
Intensive care medicine
Medical sciences
Middle Aged
Prognosis
Prospective Studies
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Summary:In a prospective randomised study we investigated end-tidal carbon dioxide levels during standard versus active compression–decompression (ACD) cardiopulmonary resuscitation (CPR) assuming that the end-tital carbon dioxide reflects cardiac output during resuscitation. In each group 60 patients with out-of-hospital cardiac arrest were treated either with the standard or the ACD method. End-tidal CO 2 ( p etCO 2, mmHg) was assessed with a side-stream capnometer following intubation and then every 2 min up to 10 min or restoration of spontaneous circulation (ROSC). There was no difference in p etCO 2 between both patient groups. However, CO 2 was significantly higher in patients who were admitted to hospital as compared to patients declared dead at the scene. All of the admitted patients had a p etCO 2 of at least 15 mmHg no later than 2 min following intubation, none of the dead patients ever exceeded 15.5 mmHg. From these data we conclude that capnometry adds valuable information to the estimation of a patient's prognosis in the field (threshold, 15 mmHg), but we could not detect any difference in p etCO 2 between ACD and standard CPR.
ISSN:0300-9572
1873-1570
DOI:10.1016/S0300-9572(98)00106-3