End-tidal carbon dioxide measurements as a prognostic indicator of outcome in cardiac arrest
Ahrens, T.; Schallom, L.; Bettorf, K.; Ellner, S.; Hurt, G.; O'Mara, V.; Ludwig, J.; George, W.; Marino, T.; Shannon, W.
American Journal of Critical Care An Official Publication American Association of Critical-Care Nurses 10(6): 391-398
2001
ISSN/ISBN: 1062-3264 PMID: 11688606 Document Number: 6698
To evaluate the use of end-tidal carbon dioxide values in predicting survival in cardiopulmonary arrest. The decision about when to terminate resuscitative efforts for patients with cardiopulmonary arrest is often subjective. End-tidal carbon dioxide values have been suggested as potential objective criteriafor making this decision. This study was a cooperative effort of the St Louis chapter of the American Association of Critical-Care Nurses and its members and involved 6 hospitals and an air evacuation service. All adult patients who had a cardiopulmonary arrest were eligiblefor the study. Once a patient with cardiac arrest was intubated, end-tidal carbon dioxide and cardiac rhythms were measured and recorded every 5 minutes for 20 minutes or until resuscitation efforts were terminated. Patients' survival at the time of the arrest, survival 24 hours after the arrest, and discharge status were followed up. A total of 127 patients were enrolled in the study. All but 1 patient with end-tidal carbon dioxide values less than 10 mm Hg died before discharge. End-tidal carbon dioxide values greater than 10 mm Hg were associated with various degrees of survival. Overall survival to discharge was less than 14%, regardless of the end-tidal carbon dioxide value. Measurements of end-tidal carbon dioxide can be used to accurately predict nonsurvival of patients with cardiopulmonary arrest. End-tidal carbon dioxide levels should be monitored during cardiopulmonary arrest and should be considered a useful prognostic value for determining the outcome of resuscitative efforts.
Document emailed within 1 workday
