Effect of End-Tidal Carbon Dioxide Measurement on Resuscitation Efficiency and Termination of Resuscitation

OBJECTIVES: In this study, the value of end-tidal carbon dioxide (ETCO(2)) levels measured by capnometry were evaluated as indicators of resuscitation effectiveness and survival in patients presenting to the emergency department with cardiopulmonary arrest. METHODS: ETCO(2) was measured after 2 minutes of compression or 150 compressions. ETCO(2) values were measured in patients that were intubated and in those who underwent chest compression. The following parameters were recorded for each patient: demographic data, chronic illness, respiration type, pre-hospital CPR, arrest rhythm, arterial blood gas measurements, ETCO(2) values with an interval of 5 minutes between the measurement and the estimated time of arrest, time to return to spontaneous circulation. RESULTS: Cardiac arrest developed in 97 cases, including 56 who were out of the hospital and 41 who were in the hospital. Fifty of these patients returned to spontaneous circulation, and just one of these had an initial ETCO(2) value below 10 mmHg. The mean of the final ETCO(2) levels was 36.4±4.46 among Patients who Return to Spontaneous Circulation (RSCPs) and 11.74±7.01 among those that died. In all rhythms; Asystole, pulseless electrical activity (PEA) and VF/VT; Overall, RSCPs had higher ETCO(2) levels than the cases who died. Among the PEA patients undergoing in-hospital arrests and those asystolic patients undergoing out of hospital arrest, the ETCO(2) values of the RSCPs were significantly higher than those of the cases who died. CONCLUSIONS: ETCO(2) levels predicted survival as well as the effectiveness of CPR for patients who received CPR and were monitored by capnometry in the emergency department. As a result, we believe that it would be suitable to use capnometry in all units where the CPR is performed.