Changes of end-tidal carbon dioxide during cardiopulmonary resuscitation from ventricular fibrillation versus asphyxial cardiac arrest

doi:10.5847/wjem.j.issn.1920-8642.2014.02.007

Abstract

Abstract:

BACKGROUND: Partial pressure of end-tidal carbon dioxide (P_ETCO₂) has been used to monitor the effectiveness of precordial compression (PC) and regarded as a prognostic value of outcomes in cardiopulmonary resuscitation (CPR). This study was to investigate changes of P_ETCO₂ during CPR in rats with ventricular fibrillation (VF) versus asphyxial cardiac arrest.
METHODS: Sixty-two male Sprague-Dawley (SD) rats were randomly divided into an asphyxial group (n=32) and a VF group (n=30). P_ETCO₂ was measured during CPR from a 6-minute period of VF or asphyxial cardiac arrest.
RESULTS: The initial values of P_ETCO₂ immediately after PC in the VF group were significantly lower than those in the asphyxial group (12.8±4.87 mmHg vs. 49.2±8.13 mmHg, P=0.000). In the VF group, the values of P_ETCO₂ after 6 minutes of PC were significantly higher in rats with return of spontaneous circulation (ROSC), compared with those in rats without ROSC (16.5±3.07 mmHg vs. 13.2±2.62 mmHg, P=0.004). In the asphyxial group, the values of P_ETCO₂ after 2 minutes of PC in rats with ROSC were significantly higher than those in rats without ROSC (20.8±3.24 mmHg vs. 13.9±1.50 mmHg, P=0.000). Receiver operator characteristic (ROC) curves of P_ETCO₂ showed significant sensitivity and specificity for predicting ROSC in VF versus asphyxial cardiac arrest.
CONCLUSIONS: The initial values of P_ETCO₂ immediately after CPR may be helpful in differentiating the causes of cardiac arrest. Changes of P_ETCO₂ during CPR can predict outcomes of CPR.

Key words: Partial pressure of end-tidal carbon dioxide, Cardiac arrest, Cardiopulmonary resuscitation, Return of spontaneous circulation, Rats

Qing-ming Lin, Xiang-shao Fang, Li-li Zhou, Yue Fu, Jun Zhu, Zi-tong Huang. Changes of end-tidal carbon dioxide during cardiopulmonary resuscitation from ventricular fibrillation versus asphyxial cardiac arrest[J]. World Journal of Emergency Medicine, 2014, 5(2): 116-121.

Figures/Tables 6

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