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Journal of The Korean Society of Emergency Medicine 1995;6(1): 231-237. |
| END-TIDAL CARBON DIOXIDE MONITORING DURING CARDIOPULMONARY RESUSCITATION |
| Sung Tae Ahn, Jun Hee Lee, Kyung Rae Kim |
| Department of Emergency Medicine, College of Medicine, Inha University |
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Published online: June 30, 1995. |
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| ABSTRACT |
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The effectiveness of ongoing cardiopulmonary resuscitation (CPR) efforts is difficult to eval uate. During a cardiac arrest and attempted resuscitation, there are no readily available noninvasive measurements that identify patients who are likely to have return of spontaneous circulation ( ROSC ). A number of studies in animals and humans suggest that systemic perfusion during arrest and CPR is related to the end-tidal volume of carbon dioxide, which is an indirect measure of pulmonary perfusion. A clinical study was done to determine whether end-tidal carbon dioxide (PetC02) monitoring during CPR could be used as a prognostic useful noninvasive indicator of resuscitation and survival. The concentration of expired carbon diox ide was measured continuously with caphnography-BCI Model 9000 Caphnographer/Oximeter ( Biochemical International, Inc., Waukesha, WI). to evaluate its clinical applicability, we performed prospective, bedside measurements of the PetC02 in patients after cardiac arrest and during CPR. We measured the PetC02 during 20 episodes of adult nontraumatic cardiac arrest and resuscitation in 16 critically ill patients during December, 1994 through February, 1995.
Spontaneous circulation was restored in eight victims(40%). The mean PetC02 of successfully resuscitated group (ROSC, N=8, 23.6 土 .5 mmHg) was higher than that of non-resuscitated group (non-ROSC, N= 12, 8.7 土 3.0 mmHg) (p<0.05). the three patients survived more than 24 hours had a higher mean PetC02 than that of the 17 patients survived less than 24 hours( 28.0 士 6.0 VS 12.3土6.5 mmHg) ( p< 0.05 ). All eight patients who were successfully resuscitated had a PetC02 of 15 mmHg or greater. No patient with a PetCO, of less than 15
mmHg was resuscitated. We concluded PetC02 monitoring during CPR are correlated with resuscitation from cardiac arrest. We also propose that measurement of the PetC02 may be a practical and noninvasive method for monitoring blood flow generated by precordial compression during CPR, and may be an almost immediate indicator of successful resuscitation.
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| Key words:
Partial pressure of End-Tidal Carbon Dioxide (PetC02 ), Cardiopulmonary Resuscitation (CPR), Return of Spontaneous Circulation(ROSC), Capnography |
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