PROGNOSTIC VALUE OF END-TIDAL CARBON-DIOXIDE PRESSURES DURING OUT-OF-HOSPITAL CARDIAC-ARREST

被引：35

作者：

ASPLIN, BR ^{[1
]}

WHITE, RD ^{[1
]}

机构：

[1] MAYO CLIN & MAYO FDN,MAYO MED SCH,ROCHESTER,MN 55905

来源：

ANNALS OF EMERGENCY MEDICINE | 1995年 / 25卷 / 06期

关键词：

D O I：

10.1016/S0196-0644(95)70203-2

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To assess the prognostic value of initial end-tidal CO2 pressures (PETCO(2)) during CPR in patients with out-of-hospital cardiac arrest (OHCA). Design: A prospective observational study using a convenience sample. Setting: Primary service area of an advanced life support (ALS) ambulance service, including a city with a population of 70,745 and the surrounding area, with a population of 30,000. Participants: Adults with nontraumatic OHCA. Interventions: Quantitative monitoring of PETCO(2) during CPR after endotracheal intubation using an infrared capnograph. Results: PETCO(2) after 1 and 2 minutes and the maximum PETCO(2) during CPR were compared between the group in which restoration of spontaneous circulation (ROSC) was achieved and the group in which it was not. PETCO(2) was measured during CPR in 27 patients. After 1 minute, PETCO(2) was higher in patients who had on-scene ROSC than in patients without ROSC (23.0 +/- 7.4 versus 13.2 +/- 14.7 mm Hg, P=.0002). After 2 minutes, PETCO(2) was higher in patients with ROSC (26.8 +/- 10.8 versus 15.4 +/- 5.7 mm Hg, P=.0019). The maximum PETCO(2) during CPR was also higher in the ROSC group (30.8 +/- 9.5 versus 22.7 +/- 8.8 mm Hg, P=.0154). Thirteen of 27 patients presented in ventricular fibrillation (VF). The 1-minute (24.3 +/- 6.8 versus 12.0 +/- 4.2 mm Hg, P=.0022), 2-minute (28.2 +/- 11.4 versus 12.4 +/- 4.3 mm Hg, P=.0088), and maximum (33.0 +/- 10.2 versus 20.6 +/- 11.1 mm Hg, P=.0316) PETCO(2) values during CPR were all significantly higher in patients in VF with ROSC. Conclusion: In this observation study of 27 patients, initial PETCO(2) during CPR with automated ventilation was prognostic for ROSC in patients with OHCA. Patients with ROSC have higher PETCO(2) values after 1 and 2 minutes than do patients without ROSC.

引用

页码：756 / 761

页数：6

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