Portal de Periódicos da CAPES

Prognostic Value Of End-Tidal Carbon Dioxide Pressures During Out-Of-Hospital Cardiac Arrest

1995; Elsevier BV; Volume: 25; Issue: 6 Linguagem: Inglês

10.1016/s0196-0644(95)70203-2

1097-6760

Brent R. Asplin, Richard D. White,

Airway Management and Intubation Techniques

Abstract Study objective: To assess the prognostic value of initial end-tidal CO 2 pressures (PETCO 2 ) during CPR in patients with out-of-hospital cardiac arrest (OHCA). Design: A prospective observational study using a convenience sample. Setting: Primary service area of an advanced life support (ALS) ambulance service, including a city with a population of 70,745 and the surrounding area, with a population of 30,000. Participants: Adults with nontraumatic OHCA. Interventions: Quantitative monitoring of PETCO 2 during CPR after endotracheal intubation using an infrared capnograph. Results: PETCO 2 after 1 and 2 minutes and the maximum PETCO 2 during CPR were compared between the group in which restoration of spontaneous circulation (ROSC) was achieved and the group in which it was not. PETCO 2 was measured during CPR in 27 patients. After 1 minute, PETCO 2 was higher in patients who had on-scene ROSC than in patients without ROSC (23.0±7.4 versus 13.2±14.7 mm Hg, P =.0002). After 2 minutes, PETCO 2 was higher in patients with ROSC (26.8±10.8 versus 15.4±5.7 mm Hg, P =.0019). The maximum PETCO 2 during CPR was also higher in the ROSC group (30.8±9.5 versus 22.7±8.8 mm Hg, P =.0154). Thirteen of 27 patients presented in ventricular fibrillation (VF). The 1-minute (24.3±6.8 versus 12.0±4.2 mm Hg, P =.0022), 2-minute (28.2±11.4 versus 12.4±4.3 mm Hg, P =.0088), and maximum (33.0±10.2 versus 20.6±11.1 mm Hg, P =.0316) PETCO 2 values during CPR were all significantly higher in patients in VF with ROSC. Conclusion: In this observation study of 27 patients, initial PETCO 2 during CPR with automated ventilation was prognostic for ROSC in patients with OHCA. Patients with ROSC have higher PETCO 2 values after 1 and 2 minutes than do patients without ROSC. [Asplin BR, White RD: Prognostic value of end-tidal carbon dioxide pressures during out-of-hospital cardiac arrest. Ann Emerg Med June 1995;25:756-761.]