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End-tidal carbon dioxide levels predict cardiac arrest

Introduction

End-tidal carbon dioxide (CO2) correlates with cardiac output during cardiopulmonary resuscitation (CPR) in cardiac arrest patients. Increasing CO2 during CPR can also indicate the return of spontaneous circulation.

Methods

CO2 was continuously monitored and recorded every 4 hours in 43 patients who were intubated and on vasopressor medications.

Results

Mean CO2 values were significantly higher in normal patients when compared with those in patients who had a cardiac arrest (30.18 ± 4.93 vs. 17.45 ± 4.76; P < 0.001). CO2 levels were significantly lower in cardiac arrest patients when compared with hypotensive patients 1, 2, 3, and 4 hours prior to a cardiac arrest (see Table 1). CO2 levels were significantly lower in cardiac arrest patients when compared with patients who were acutely withdrawn from care 1, 2, 3, and 4 hours prior to the event (see Table 2).

Table 1 End-tidal CO2 5 hours prior to cardiac arrest compared with hypotension
Table 2 End-tidal CO2 5 hours prior to cardiac arrest versus acute withdrawal of care

Conclusions

CO2 levels decrease prior to cardiac arrest and are signi-ficantly lower than prior to hypotensive or acute withdrawal of care events. Further study needs to be done on a larger scale to see whether these results hold true.

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Correspondence to H Manyam.

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Manyam, H., Thiagarajah, P., Patel, G. et al. End-tidal carbon dioxide levels predict cardiac arrest. Crit Care 15, P80 (2011). https://doi.org/10.1186/cc9500

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Keywords

  • Public Health
  • Dioxide
  • Carbon Dioxide
  • Cardiac Output
  • Emergency Medicine