Significance of End-Tidal Carbon Dioxide Monitoring As a Prognostic Factor of ROSC During Cardiopulmonary Resuscitation

Eo,  Eun Kyung; Jung,  Koo Young

J Korean Soc Emerg Med > Volume 9(4); 1998 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 1998;9(4): 551-559.

Significance of End-Tidal Carbon Dioxide Monitoring As a Prognostic Factor of ROSC During Cardiopulmonary Resuscitation

ABSTRACT

BACKGROUND: It is difficult to evaluate the effectiveness of ongoing cardiopulmonary resuscitation(CPR). Recent studies suggest that continuous end-tidal carbon dioxide(ETC02) monitoring may be useful non-invasive indicator of CPR. The purpose of this study is to determine whether ETC02 monitoring during CPR could be used as a prognostic indicator of resuscitation and survival. METHOD: A prospective, clinical study was performed from May 1997 to April 1998 at the department of emergency medicine, Ewha Womans University Mokdong hospital. All patients were immediately connected to mainstream capnometer sensor between the tube and the bag after endotracheal intubation using infrared capnometer. RESULT: The study included 70 patients (39 were men) with a mean age of 55+/-16 years. 37 patients with return of spontaneous circulation(ROSC) had higher maximal ETCO2 during CPR than 33 Patients without ROSC (26.9+/-19.4 vs 10.2+/- 9.0mmHg, p=0.0001). The ETCO2 was not significantly different in relation to age, gender, initial rhythm, and survival time after ROSC. But there was significant difference in immediate cause of arrest in ROSC group (P=0.0016). When maximal ETC02 was less than 10mmHg, we observed sensitivity of 83.8%, specificity of 54.5% in predicting ROSC. There were 6 patients with ROSC in spite of maximal ETCO2 was less than 10mmHg.
CONCLUSION:
Continuous ETCOB monitoring during CPR may be useful, noninvasive, and valuable predictor of successful resuscitation and survival from cardiac arrest. But ETCO2 should lot be used as a single indicator for the withdrawal of CPR.