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. 2014;5(2):116-21.
doi: 10.5847/wjem.j.issn.1920-8642.2014.02.007.

Changes of end-tidal carbon dioxide during cardiopulmonary resuscitation from ventricular fibrillation versus asphyxial cardiac arrest

Qing-Ming Lin  1 , Xiang-Shao Fang  2 , Li-Li Zhou  2 , Yue Fu  2 , Jun Zhu  2 , Zi-Tong Huang  2
Affiliations

Changes of end-tidal carbon dioxide during cardiopulmonary resuscitation from ventricular fibrillation versus asphyxial cardiac arrest

Qing-Ming Lin et al. World J Emerg Med. 2014.

Abstract

Background: Partial pressure of end-tidal carbon dioxide (PETCO2) has been used to monitor the effectiveness of precordial compression (PC) and regarded as a prognostic value of outcomes in cardiopulmonary resuscitation (CPR). This study was to investigate changes of PETCO2 during CPR in rats with ventricular fibrillation (VF) versus asphyxial cardiac arrest.

Methods: Sixty-two male Sprague-Dawley (SD) rats were randomly divided into an asphyxial group (n=32) and a VF group (n=30). PETCO2 was measured during CPR from a 6-minute period of VF or asphyxial cardiac arrest.

Results: The initial values of PETCO2 immediately after PC in the VF group were significantly lower than those in the asphyxial group (12.8±4.87 mmHg vs. 49.2±8.13 mmHg, P=0.000). In the VF group, the values of PETCO2 after 6 minutes of PC were significantly higher in rats with return of spontaneous circulation (ROSC), compared with those in rats without ROSC (16.5±3.07 mmHg vs. 13.2±2.62 mmHg, P=0.004). In the asphyxial group, the values of PETCO2 after 2 minutes of PC in rats with ROSC were significantly higher than those in rats without ROSC (20.8±3.24 mmHg vs. 13.9±1.50 mmHg, P=0.000). Receiver operator characteristic (ROC) curves of PETCO2 showed significant sensitivity and specificity for predicting ROSC in VF versus asphyxial cardiac arrest.

Conclusions: The initial values of PETCO2 immediately after CPR may be helpful in differentiating the causes of cardiac arrest. Changes of PETCO2 during CPR can predict outcomes of CPR.

Keywords: Cardiac arrest; Cardiopulmonary resuscitation; Partial pressure of end-tidal carbon dioxide; Rats; Return of spontaneous circulation.

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Conflict of interest statement

Conflicts of interest: The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
Partial pressure of end-tidal carbon dioxide (PETCO2) during PC in VF and asphyxial cardiac arrests.
Figure 2
Figure 2
Partial pressure of end-tidal carbon dioxide (PETCO2) before and after VF cardiac arrest. PC: precordial compression; ROSC: return of spontaneous circulation.
Figure 3
Figure 3
MAP before and after VF cardiac arrest. PC: precordial compression; ROSC: return of spontaneous circulation.
Figure 4
Figure 4
Partial pressure of end-tidal carbon dioxide (PETCO2) before and after asphyxial cardiac arrest. PC: precordial compression; ROSC: return of spontaneous circulation.
Figure 5
Figure 5
MAP before and after asphyxial cardiac arrest. PC: precordial compression; ROSC: return of spontaneous circulation.
Figure 6
Figure 6
ROC curves for partial pressure of end-tidal carbon dioxide (PETCO2) in terms of predicting ROSC when measured at 6 minutes after precordial compression for VFCA rats (A) or at 2 minutes after precordial compression for ACA rats (B). The sensitivities and specificities threshold values for predicting ROSC. ROSC: return of spontaneous circulation; VFCA: ventricular fibrillation cardiac arrest; ACA: asphyxial cardiac arrest.
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