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Capnography during cardiopulmonary resuscitation: Current evidence and future directions.

Kodali BS, Urman RD - J Emerg Trauma Shock (2014)

Bottom Line: Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports.Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO2 (PETCO2) and cardiac output that can indicate the return of spontaneous circulation (ROSC).There is emerging evidence that PETCO2 values can guide the initiation of extracorporeal life support (ECLS) in refractory cardiac arrest (RCA).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

ABSTRACT
Capnography continues to be an important tool in measuring expired carbon dioxide (CO2). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO2 (PETCO2) and cardiac output that can indicate the return of spontaneous circulation (ROSC). Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO2 values can guide the initiation of extracorporeal life support (ECLS) in refractory cardiac arrest (RCA). There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes.

No MeSH data available.


Related in: MedlinePlus

Example of a capnography unit mounted on a movable code stand
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Figure 6: Example of a capnography unit mounted on a movable code stand

Mentions: Based on the current guidelines of AHA/ACLS, our institution has mounted a capnography unit on a movable code stand [Figure 6]. The unit is turned on at the first notification of the code so that it undergoes the calibration process by the time the code team arrives at the code location. In addition, the stand has a video laryngoscope for an unanticipated difficult intubation.


Capnography during cardiopulmonary resuscitation: Current evidence and future directions.

Kodali BS, Urman RD - J Emerg Trauma Shock (2014)

Example of a capnography unit mounted on a movable code stand
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4231274&req=5

Figure 6: Example of a capnography unit mounted on a movable code stand
Mentions: Based on the current guidelines of AHA/ACLS, our institution has mounted a capnography unit on a movable code stand [Figure 6]. The unit is turned on at the first notification of the code so that it undergoes the calibration process by the time the code team arrives at the code location. In addition, the stand has a video laryngoscope for an unanticipated difficult intubation.

Bottom Line: Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports.Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO2 (PETCO2) and cardiac output that can indicate the return of spontaneous circulation (ROSC).There is emerging evidence that PETCO2 values can guide the initiation of extracorporeal life support (ECLS) in refractory cardiac arrest (RCA).

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.

ABSTRACT
Capnography continues to be an important tool in measuring expired carbon dioxide (CO2). Most recent Advanced Cardiac Life Support (ACLS) guidelines now recommend using capnography to ascertain the effectiveness of chest compressions and duration of cardiopulmonary resuscitation (CPR). Based on an extensive review of available published literature, we selected all available peer-reviewed research investigations and case reports. Available evidence suggests that there is significant correlation between partial pressure of end-tidal CO2 (PETCO2) and cardiac output that can indicate the return of spontaneous circulation (ROSC). Additional evidence favoring the use of capnography during CPR includes definitive proof of correct placement of the endotracheal tube and possible prediction of patient survival following cardiac arrest, although the latter will require further investigations. There is emerging evidence that PETCO2 values can guide the initiation of extracorporeal life support (ECLS) in refractory cardiac arrest (RCA). There is also increasing recognition of the value of capnography in intensive care settings in intubated patients. Future directions include determining the outcomes based on capnography waveforms PETCO2 values and determining a reasonable duration of CPR. In the future, given increasing use of capnography during CPR large databases can be analyzed to predict outcomes.

No MeSH data available.


Related in: MedlinePlus