Author + information
- Received July 18, 1988
- Revision received October 18, 1988
- Accepted December 5, 1988
- Published online April 1, 1989.
- Karl B. Kern, MD, FACC1,∗,
- Arthur B. Sanders, MD∗,
- William D. Voorhees, PHD†,
- Charles F. Babbs, MD, PHD†,
- Willis A. Tacker, MD, PHD† and
- Gordon A. Ewy, MD, FACC∗
- ↵1Author to whom correspondence should be addressed.
Expired end-tidal carbon dioxide (Pco2) measurements made during cardiopulmonary resuscitation have correlated with cardiac output and coronary perfusion pressure when wide ranges of blood flow are included. The utility of such measurements for predicting resuscitation outcome during the low flow state associated with closed chest cardiopulmonary resuscitation remains uncertain. Expired end-tidal Pco2 and coronary perfusion pressures were measured in 15 mongrel dogs undergoing 15 min of closed chest cardiopulmonary resuscitation after a 3 min period of untreated ventricular fibrillation.
In six successfully resuscitated dogs, the mean expired end-tidal Pco2 was significantly higher than that in nine nonresuscitated dogs only after 14 min of cardiopulmonary resuscitation (6.2 ± 1.2 versus 3.4 ± 0.8 mm Hg; p < 0.05). No differences in expired end-tidal Pco2 values were found at 2, 7 or 12 min of cardiopulmonary resuscitation. A significant decline in end-tidal Pco2 levels during the resuscitation effort was seen in the nonresuscitated group (from 6.3 ± 0.8 to 3.4 ± 0.8 mm Hg; p < 0.05); the successfully resuscitated group had constant Pco2 levels throughout the 15 min of cardiac arrest (from 6.8 ± 1.1 to 6.2 ± 1.2 mm Hg). Changes in expired PC02 levels during cardiopulmonary resuscitation may be a useful noninvasive predictor of successful resuscitation and survival from cardiac arrest.
☆ This work was supported in part by grants from the American Heart Association, Arizona Affiliate, Flinn Foundation, Phoenix, Arizona and by Grants HL-29398 and HL-35996 from the National Heart, Lung, and Blood Institute. Bethesda, Maryland.
- Received July 18, 1988.
- Revision received October 18, 1988.
- Accepted December 5, 1988.