Does the end-tidal carbon dioxide (EtCO2) concentration have prognostic value during out-of-hospital cardiac arrest?

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We aimed to investigate the utility of end-tidal carbon dioxide concentration as a prognostic indicator of initial outcome of resuscitation, we conducted a prospective study of EtCO2 in adult victims of out-of-hospital non-traumatic cardiac arrest. We prospectively studied 139 adult patients. The initial, final, average, minimal and maximal EtCO2 was significantly higher in resuscitated patients than in non-resuscitated patients. Using an initial, average and final EtCO2 value of 10 mmHg correctly identified 100% of the patients who were subsequently resuscitated with an acceptable specificity (74.1%; 90%; 81.4%). Important observation from this study is that none of the patients with an average, initial and final EtCO2 level of less than 10 mmHg were resuscitated. Data from this prospective clinical trial indicate that initial, average and final EtCO2 monitoring during CPR is correlated with resuscitation. End-tidal CO2 monitoring has potential as a noninvasive indicator of cardiac output during resuscitation and a prognostic indicator for resuscitation.

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