Carbon dioxide levels during pre-hospital active compression-decompressionversus standard cardiopulmonary resuscitation

In a prospective randomised study we investigated end-tidal carbon dioxide levels during standard versus active compression-decompression (ACD) cardio pulmonary resuscitation (CPR) assuming that the end-tital carbon dioxide re flects cardiac output during resuscitation, In each group 60 patients with out-of-hospital cardiac arrest were treated either with the standard or the ACD method. End-tidal CO2 (p(et)CO(2), mmHg) was assessed with a side-stre am capnometer following intubation and then every 2 min up to 10 min or res toration of spontaneous circulation (ROSC). There was no difference in p(et )CO(2) between both patient groups. However, CO2 was significantly higher i n patients who were admitted to hospital as compared to patients declared d ead at the scene. All of the admitted patients had a p(et)CO(2) of at least 15 mmHg no later than 2 min following intubation, none of the dead patient s ever exceeded 15.5 mmHg. From these data we conclude that capnometry adds valuable information to the estimation of a patient's prognosis in the fie ld (threshold, 15 mmHg), but we could not detect any difference in p(et)CO( 2) between ACD and standard CPR. (C) 1998 Elsevier Science Ireland Ltd. All rights reserved.