Role of End-Tidal CO_2 Monitoring in Patients Intubated and Resuscitated in the Emergency Department

Authors: ÖZGÜR KARCIOĞLU, YASEMİN KARCIOĞLU

Abstract: Objective: We examined the reliability of end-tidal CO_2 (ETCO_2 ) level in predicting mortality after endotracheal intubation in emergency situations. Methods: In this prospective study, the reliability of ETCO_2 monitoring in the emergency setting as a useful predictor of outcome was investigated in 36 adult patients with pending cardiopulmonary collapse. The cardiopulmonary resuscitation (CPR) procedure was performed as usual and the cardiac rhythm, arterial O_2 saturation, non- invasive blood pressure and ETCO_2 levels were continuously monitored in all the patients. Results: Patients with an ETCO_2 concentration below 0.5% had significantly lower rates of survival. The sensitivity and specificity values of end-tidal CO_2 levels equal to or greater than 0.5% in predicting survival were 100% and 42.8%, respectively. None of the 8 patients with levels below 0.5% survived. An end-tidal CO 2 concentration level of 0.5% served to discriminate between survivors and non-survivors. Conclusions: These results suggest that the initial ETCO_2 concentration can be an important predictor of outcome, especially with regard to mortality in patients undergoing endotracheal intubation.

Keywords: End-Tidal CO_2 , Monitoring, Mortality, Cardiopulmonary Resuscitation

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