Purpose of the Study:
To investigate the prognostic value of end-tidal expiratory pressure of carbon dioxide (ETCO2) during cardiopulmonary resuscitation (CPR) in a porcine model of cardiac arrest (CA).
Materials and Methods:
24 mechanically ventilated pigs under general anesthesia were included in the study. Ventricular fibrillation was induced by transvenous pacing and at the same time mechanical ventilation (MV) was discontinued. After a period of 7min, CPR was initiated by the use of a mechanical CPR device (LUCAS) and MV was started again. Five min later, rhythm recognition was performed, shock was delivered and the Advanced Life Support (ALS) algorithm was followed according to the ERC Guidelines. Depending on return of spontaneous circulation (ROSC) achievement, pigs were divided into two Groups, A (ROSC) and B (CPR was terminated after 40min without ROSC). ETCO2 was determined by the use of waveform capnography before CA (Phase 0), 7min after CA (Phase 1) and, thereafter, every 1min during chest compressions and until ROSC was achieved (Group A) or for 40min (Group B) (Phases 2-41).
Results:
ETCO2 alterations are depicted on the Graph. Immediately after cessation of cardiac activity, ETCO2 readings changed to zero, as expected, in both Groups. During CPR, ETCO2 values in Group A remained higher, in a statistically significant manner, compared to the corresponding ones in Group B. On the contrary, ETCO2 values in Group B were lower from the beginning, declined severely after the first 10min and reached zero levels at 20min.
Conclusions: Based on the results of our study, it seems that ETCO2 values during CPR might have a prognostic value and could be associated with the outcome.
References: Sandroni C, De Santis P, D’Arrigo S. Capnography during cardiac arrest. Resuscitation 2018; 132: 73-77

PROGNOSTIC VALUE OF ETCO2 DURING CARDIOPULMONARY RESUSCITATION IN A PORCINE MODEL OF CARDIAC ARREST

Implementation of the Guidelines - How do we put the new ERC Guidelines into practice?

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