End-tidal carbon dioxide (ETCO2) at intubation and its increase after 10 minutes resuscitation predicts survival with good neurological outcome in out-of-hospital cardiac arrest patients

被引:0
作者
Baldi, Enrico [1 ,2 ]
Caputo, Maria Luce [3 ]
Klersy, Catherine [4 ]
Benvenuti, Claudio [3 ]
Contri, Enrico [5 ]
Palo, Alessandra [5 ]
Primi, Roberto
Cresta, Ruggero [3 ]
Compagnoni, Sara [6 ]
Cianella, Roberto [7 ]
Burkart, Roman [3 ]
De Ferrari, Gaetano Maria [6 ]
Auricchio, Angelo [2 ,3 ]
Savastano, Simone
机构
[1] Fdn IRCCS Policlin San Matteo, Viale Golgi 19, I-27100 Pavia, Italy
[2] Ente Osped Cantonale, Cardioctr Ticino Inst, Lugano, Switzerland
[3] Fdn TicinoCuore, Lugano, Switzerland
[4] Fdn IRCCS Policlin San Matteo, Unit Clin Epidemiol & Biostat, Pavia, Italy
[5] Fdn IRCCS Policlin San Matteo, AREU Azienda Regionale Emergenza Urgenza AAT Pavia, Pavia, Italy
[6] Univ Pavia, Dept Mol Med, Pavia, Italy
[7] Federaz Cantonale Ticinese Servizi Autoambulanze, Lugano, Switzerland
关键词
Out-of-hospital cardiac arrest; Survival; Good neurological outcome; ETCO2; CARDIOPULMONARY-RESUSCITATION;
D O I
暂无
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Aim: To evaluate whether end-tidal carbon dioxide (ETCO2) value at intubation and its early increase (10 min) after intubation predict both the sur-vival to hospital admission and the survival at hospital discharge, including good neurological outcome (CPC 1-2), in patients with out-of-hospital cardiac arrest (OHCA).Methods: All consecutive OHCA patients of any etiology between 2015 and 2018 in Pavia Province (Italy) and Ticino Region (Switzerland) were considered. Patients died before ambulance arrival, with a "do-not-resuscitate" order, without ETCO2 value or with incomplete data were excluded.Results: The study population consisted of 668 patients. An ETCO2 value at intubation > 20 mmHg and its increase 10 min after intubation were independent predictors (after correction for known predictors of OHCA outcome) of survival to hospital admission and survival at hospital discharge. Relative to hospital discharge with good neurological outcome, ETCO2 at intubation and its 10-min change were confirmed predictors both individ-ually and in a bivariable analysis (OR 1.83, 95 %CI 1.02-3.3; p = 0.04 and OR 3.9, 95 %CI 1.97-7.74; p < 0.001, respectively). This was confirmed also when accounting for gender, age, etiology and location. After further adjustment for bystander and CPR status, presenting rhythm and EMS arrival time, the ETCO2 change remained an independent predictor.Conclusions: ETCO2 value > 20 mmHg at intubation and its increase during resuscitation improve the prediction of survival at hospital discharge with good neurological outcome of OHCA patients. ETCO2 increase during resuscitation is a more powerful predictor than ETCO2 at intubation. A larger prospective study to confirm this finding appears warranted.
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页码:197 / 207
页数:11
相关论文
共 14 条
[1]  
Ahrens T, 2001, Am J Crit Care, V10, P391
[2]  
Baldi E, 2022, RESUSCITATION, V181, P197
[3]   PREDICTION OF OUTCOME OF CARDIOPULMONARY RESUSCITATION FROM END-TIDAL CARBON-DIOXIDE CONCENTRATION [J].
CALLAHAM, M ;
BARTON, C .
CRITICAL CARE MEDICINE, 1990, 18 (04) :358-362
[4]   End-tidal carbon dioxide during cardiopulmonary resuscitation in humans presenting mostly with asystole: A predictor of outcome [J].
Cantineau, JP ;
Lambert, Y ;
Merckx, P ;
Reynaud, P ;
Porte, F ;
Bertrand, C ;
Duvaldestin, P .
CRITICAL CARE MEDICINE, 1996, 24 (05) :791-796
[5]   The association between end-tidal CO2 and return of spontaneous circulation after out-of-hospital cardiac arrest with pulseless electrical activity [J].
Crickmer, Michael ;
Drennan, Ian R. ;
Turner, Linda ;
Cheskes, Sheldon .
RESUSCITATION, 2021, 167 :76-81
[6]   End tidal CO2 and cerebral oximetry for the prediction of return of spontaneous circulation during cardiopulmonary resuscitation [J].
Engel, Thomas W., II ;
Thomas, Craig ;
Medado, Patrick ;
Bastani, Aveh ;
Reed, Brian ;
Millis, Scott ;
O'Neil, Brian J. .
RESUSCITATION, 2019, 139 :174-181
[7]  
Grmec S, 2001, Eur J Emerg Med, V8, P263
[8]   Assessment of the evolution of end-tidal carbon dioxide within chest compression pauses to detect restoration of spontaneous circulation [J].
Julio Gutierrez, Jose ;
Leturiondo, Mikel ;
Ruiz de Gauna, Sofia ;
Maria Ruiz, Jesus ;
Azcarate, Izaskun ;
Maria Gonzalez-Otero, Digna ;
Francisco Urtusagasti, Juan ;
Russell, James Knox ;
Daya, Mohamud Ramzan .
PLOS ONE, 2021, 16 (05)
[9]   End-tidal carbon dioxide and outcome of out-of-hospital cardiac arrest [J].
Levine, RL ;
Wayne, MA ;
Miller, CC .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (05) :301-306
[10]   The use of end-tidal carbon dioxide (ETCO2) measurement to guide management of cardiac arrest: A systematic review [J].
Paiva, Edison F. ;
Paxton, James H. ;
O'Neil, Brian J. .
RESUSCITATION, 2018, 123 :1-7