A comparison of carotid doppler ultrasonography and capnography in evaluating the efficacy of CPR

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Abstract

Introduction and purpose

The end-tidal carbon dioxide (ETCO2) measurement is accepted as the gold standard method for assessing cardiopulmonary resuscitation (CPR) efficacy. In recent studies, the use of Carotid Doppler Ultrasonography has become widespread in showing CPR efficacy. In the present study, the carotid blood flow measurement was compared with ETCO2 measurement and an evaluation was made of whether this method could be used as an alternative method to capnography in the assessment of CPR efficacy.

Material and method

This study was conducted on patients who presented at the Emergency Department (ED) with non-traumatic arrest or began to suffer from arrest during emergency service follow-up. The main carotid artery peak systolic velocity (PSV), end diastolic velocity (EDV) and time-dependent mean flow velocity (MNV), and ETCO2 values were measured and recorded after the 100th chest pressure of the CPR cycle and the results were statistically analyzed.

Results

The mean age of the patients was 54.5 ± 12.3 years and 65.6% of the patients were male. The mean values of patients measured from the carotid artery during the CPR were PSV 67.1 ± 17.3, EDV 16.3 ± 4.5, MNV 25.5 ± 8.1 and ETCO2 22.2 ± 8.1. A significant difference was found between in-hospital and out-of-hospital arrests in terms of patient outcome (return of spontaneous circulation (ROSC) and death) (p < 0.05). The mean ETCO2 values of those who died were found to be lower than those of the ROSC group (p < 0.05). Although there was a positive and low-level of correlation between the ETCO2 values and PSV values, and a positive and very low-level of correlation between the EDV and MNV values of all patients, these correlations were not statistically significant. (p > 0.05).

Conclusion

A low correlation was found between the PSV and ETCO2 values. With effective CPR, the results close to carotid blood flow in normal healthy individuals were obtained. However, the study showed that carotid blood flow measurement results during CPR were not as valuable as ETCO2 in demonstrating CPR efficacy.

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