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The use of end-tidal carbon dioxide monitoring in patients with hypotension in the emergency department.

Kheng CP, Rahman NH - Int J Emerg Med (2012)

Bottom Line: Early ETCO2 measurements were found to be significantly lower in patients who did not survive to hospital admission (p = 0.005).All patients who had ETCO2 ≤ 12mmHg died in the ED.However, normal ETCO2 does not ensure patient survival.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Emergency Medicine, School of Medical Sciences, USM, Kota Bharu, 16150, Malaysia. nhliza@hotmail.com.

ABSTRACT

Background: The aim of this study was to determine the usefulness of end tidal carbon dioxide (ETCO2) monitoring in hypotensive shock patients presenting to the ED.

Methods: This was a prospective observational study in a tertiary ED. One hundred three adults in shock with hypotension presenting to the ED were recruited into the study. They were grouped according to different types of shock, hypovolemic, cardiogenic, septic and others. Vital signs and ETCO2 were measured on presentation and at 30-min intervals up to 120 min. Blood gases and serum lactate levels were obtained on arrival. All patients were managed according to standard protocols and treatment regimes. Patient survival up to hospital admission and at 30 days was recorded.

Results: Mean ETCO2 for all patients on arrival was 29.07 ± 9.96 mmHg. Average ETCO2 for patients in hypovolemic, cardiogenic and septic shock was 29.64 ± 11.49, 28.60 ± 9.87 and 27.81 ± 7.39 mmHg, respectively. ETCO2 on arrival was positively correlated with systolic and diastolic BP, MAP, bicarbonate, base excess and lactate when analyzed in all shock patients. Early ETCO2 measurements were found to be significantly lower in patients who did not survive to hospital admission (p = 0.005). All patients who had ETCO2 ≤ 12mmHg died in the ED. However, normal ETCO2 does not ensure patient survival.

Conclusion: The use of ETCO2 in the ED has great potential to be used as a method of non-invasive monitoring of patients in shock.

No MeSH data available.


Related in: MedlinePlus

Flowchart of the study.
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Figure 1: Flowchart of the study.

Mentions: This prospective observational study was conducted in a regional tertiary referral center with annual patient attendance to ED of approximately 60,000. It is a teaching hospital for undergraduate and residency-based programs with many specialized fields including Emergency Medicine. All patients who presented to the ED from 1 June 2009 to 30 December 2009 with clinical signs of shock managed in the resuscitation zone were enrolled in this study. No randomization was done. Consent was obtained from either the patient or next of kin by signing the consent form (Figure 1).


The use of end-tidal carbon dioxide monitoring in patients with hypotension in the emergency department.

Kheng CP, Rahman NH - Int J Emerg Med (2012)

Flowchart of the study.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3585511&req=5

Figure 1: Flowchart of the study.
Mentions: This prospective observational study was conducted in a regional tertiary referral center with annual patient attendance to ED of approximately 60,000. It is a teaching hospital for undergraduate and residency-based programs with many specialized fields including Emergency Medicine. All patients who presented to the ED from 1 June 2009 to 30 December 2009 with clinical signs of shock managed in the resuscitation zone were enrolled in this study. No randomization was done. Consent was obtained from either the patient or next of kin by signing the consent form (Figure 1).

Bottom Line: Early ETCO2 measurements were found to be significantly lower in patients who did not survive to hospital admission (p = 0.005).All patients who had ETCO2 ≤ 12mmHg died in the ED.However, normal ETCO2 does not ensure patient survival.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Emergency Medicine, School of Medical Sciences, USM, Kota Bharu, 16150, Malaysia. nhliza@hotmail.com.

ABSTRACT

Background: The aim of this study was to determine the usefulness of end tidal carbon dioxide (ETCO2) monitoring in hypotensive shock patients presenting to the ED.

Methods: This was a prospective observational study in a tertiary ED. One hundred three adults in shock with hypotension presenting to the ED were recruited into the study. They were grouped according to different types of shock, hypovolemic, cardiogenic, septic and others. Vital signs and ETCO2 were measured on presentation and at 30-min intervals up to 120 min. Blood gases and serum lactate levels were obtained on arrival. All patients were managed according to standard protocols and treatment regimes. Patient survival up to hospital admission and at 30 days was recorded.

Results: Mean ETCO2 for all patients on arrival was 29.07 ± 9.96 mmHg. Average ETCO2 for patients in hypovolemic, cardiogenic and septic shock was 29.64 ± 11.49, 28.60 ± 9.87 and 27.81 ± 7.39 mmHg, respectively. ETCO2 on arrival was positively correlated with systolic and diastolic BP, MAP, bicarbonate, base excess and lactate when analyzed in all shock patients. Early ETCO2 measurements were found to be significantly lower in patients who did not survive to hospital admission (p = 0.005). All patients who had ETCO2 ≤ 12mmHg died in the ED. However, normal ETCO2 does not ensure patient survival.

Conclusion: The use of ETCO2 in the ED has great potential to be used as a method of non-invasive monitoring of patients in shock.

No MeSH data available.


Related in: MedlinePlus