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Article
January 23, 1987

End-Tidal Carbon Dioxide Monitoring During Cardiopulmonary Resuscitation

Author Affiliations

From the Pulmonary (Dr Garnett) and Cardiology (Dr Ornato) Sections, Department of Internal Medicine, and the Departments of Pharmacy (Dr Gonzalez) and Anesthesiology (Dr Johnson), Medical College of Virginia, Richmond.

From the Pulmonary (Dr Garnett) and Cardiology (Dr Ornato) Sections, Department of Internal Medicine, and the Departments of Pharmacy (Dr Gonzalez) and Anesthesiology (Dr Johnson), Medical College of Virginia, Richmond.

JAMA. 1987;257(4):512-515. doi:10.1001/jama.1987.03390040128031
Abstract

The end-tidal carbon dioxide (CO2) concentration has been found to correlate with cardiac output during and after cardiopulmonary resuscitation (CPR) in animal models. We monitored end-tidal CO2 values continuously during cardiac resuscitation in 23 humans while ventilation was held constant with a computercontrolled CPR Thumper. This report focuses on ten of the 23 patients who experienced return of spontaneous circulation (ROSC) during monitoring. There was no significant difference in the end-tidal CO2 value of patients without ROSC (1.8% ±0.9%) and the end-tidal CO2 value of patients before ROSC in patients who had ROSC (1.7%± ±0.6%). The end-tidal CO2 concentration increased immediately in all patients who had ROSC, from 1.7% ±0.6% to 4.6% ±1.4%, then gradually returned to a new baseline (3.1% ± 0.9%). Change in the end-tidal CO2 value was often the first clinical indicator that ROSC had occurred. Our findings suggest that end-tidal CO2 monitoring may provide clinically useful information that can be used to guide therapy during CPR.

(JAMA 1987;257:512-515)

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