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End-tidal carbon dioxide during out-of-hospital cardiac arrest resuscitation: comparison of active
G A Orliaguet1, P A Carli, A Rozenberg
1Service d'Aide Médicale Urgente (SAMU) de Paris, Department of Anesthesiology, Hôpital Necker.
Study Objectives:
To compare the maximal end-tidal carbon dioxide pressure (ETCO2 peak) values obtained during standard (S-CPR) and active compression-decompression CPR (ACD-CPR) during prolonged resuscitation in out-of-hospital cardiac arrest.
Design:
Prospective, randomized crossover study.
Setting:
City with a population of 3.5 million, served by an emergency medical service system providing advanced cardiac life support.
Participants:
Patients with nontraumatic out-of-hospital cardiac arrest.
Interventions:
Patients were randomly assigned to receive first, for a period of 3 minutes, either ACD-CPR or S-CPR; then the two methods were alternated. ETCO2 was continuously monitored and computed.
Measurements And Results:
Sixteen patients (48 +/- 20 years old) were included; in 12, return of spontaneous circulation was achieved, and 5 were admitted alive to the hospital. A statistically significant increase in ETCO2 peak was obtained with ACD-CPR (27.6 +/- 3 mm Hg) compared with S-CPR (15.6 +/- 2.2 mm Hg). No major adverse effect possibly related to ACD-CPR was observed.
Conclusion:
This prospective study suggests that ACD-CPR may improve cardiac output compared with S-CPR.