Predicting the lack of ROSC during pre-hospital CPR: Should an end-tidal CO₂ of 1.3 kPa be used as a cut-off value?

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• 作者：Leif Rogn氓s ; Troels Martin Hansen ; Hans Kirkegaard ; Else T酶nnesen
• 关键词：Cardiac arrest ; End-tidal CO2 ; Pre-hospital critical care ; Emergency medical system ; Helicopter emergency medical system ; Critical decision making
• 刊名：Resuscitation
• 出版年：March, 2014
• 年：2014
• 卷：85
• 期：3
• 页码：332-335
• 全文大小：341 K

文摘

Aim

The aim of this study was to investigate if an initial ETCO₂ value at or below 1.3 kPa can be used as a cut-off value for whether return of spontaneous circulation during pre-hospital cardio-pulmonary resuscitation is achievable or not.

Materials and methods

We prospectively registered data according to the Utstein-style template for reporting data from pre-hospital advanced airway management from February 1st 2011 to October 31st 2012. Included were consecutive patients at all ages with pre-hospital cardiac arrest treated by eight anaesthesiologist-staffed pre-hospital critical care teams in the Central Denmark Region.

Results

We registered data from 595 cardiac arrest patients; in 60.2% (n = 358) of these cases the pre-hospital critical care teams performed pre-hospital advanced airway management beyond bag-mask ventilation. An initial end-tidal CO₂ measurement following pre-hospital advanced airway management were available in 75.7% (n = 271) of these 358 cases. We identified 22 patients, who had an initial end-tidal CO₂ at or below 1.3 kPa. Four of these patients achieved return of spontaneous circulation.

Conclusion

Our results indicates that an initial end-tidal CO₂ at or below 1.3 kPa during pre-hospital CPR should not be used as a cut-off value for the achievability of return of spontaneous circulation.