Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients

Yıl: 2019 Cilt: 49 Sayı: 5 Sayfa Aralığı: 1298 - 1302 Metin Dili: İngilizce DOI: 10.3906/sag-1812-156 İndeks Tarihi: 13-05-2020

Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients

Öz:
Background/aim: This study aimed to evaluate the usefulness of blood gas and end-tidal carbon dioxide (EtCO2) measurements forpredicting return of spontaneous circulation (ROSC) and for evaluating post-ROSC neurological survival.Materials and methods: This was a prospective case control study utilizing Atatürk University’s database of adult nontraumatic patients(over 18 years old) with out-of-hospital cardiac arrest (OHCA) over the course of a year. The neurological status of the patients wasevaluated after 1 h at ROSC and at hospital discharge, as defined by the cerebral performance category score. The blood gas parameterspH, PO2, PCO2, lactate, and BE were compared with EtCO2 from capnography and arteriol/alveolar carbon dioxide difference (AaDCO2)by using both blood gas and capnography upon admission to the emergency department and at ROSC.Results: A total of 155 patients were included in the study to form the control group with ROSC. The PO2, PCO2, and AaDCO2 valuesshowed a prognostic marker for the supply of ROSC (P < 0.05). The EtCO2,lactate, and BE values measured by the blood gas were foundto be insignificant in the prediction of ROSC (P > 0.05). Conversely, AaDCO2 was found to be significant in ROSC estimation (P < 0.05),but not in neurological evaluation (P > 0.05).Conclusion: Blood gas parameters and EtCO2 are sufficient in predicting ROSC. The value of AaDCO2 calculated using EtCO2 and PO2may be used in predicting the prognosis of OHCA patients, but this value does not provide any conclusions concerning neurologicalsurvival.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Sasson C1, Rogers MA, Dahl J, Kellermann AL. Predictors of survival from out-of-hospital cardiac arrest: a systematic review and meta-analysis. Circulation: Cardiovascular Quality and Outcomes 2010; 3(1): 63-81. doi: 10.1161/ CIRCOUTCOMES.109.889576
  • 2. Girotra S, Cram P, Spertus JA, Nallamothu BK, Li Y et al. Hospital variation in survival trends for in-hospital cardiac arrest. Journal of the American Heart Association 2014; 10: 3(3): e000871. doi: 10.1161/JAHA.114.000871
  • 3. Neumar RW, Nolan JP, Adrie C, Aibiki M, Berg RA et al. Postcardiac arrest syndrome: epidemiology, pathophysiology, treatment, and prognostication. Circulation 2008; 118(23): 2452-2483. doi: 10.1161/CIRCULATIONAHA.108.190652
  • 4. Kim YJ, Lee YJ, Ryoo SM, Sohn CH, Ahn S et al. Role of blood gas analysis during cardiopulmonary resuscitation in out-ofhospital cardiac arrest patients. Medicine (Baltimore) 2016; 95(25): e3960. doi: 10.1097/MD.0000000000003960
  • 5. Choi SH, Kim JY, Yoon YH, Park SJ, Moon SW et al. The use of transcutaneous CO2 monitoring in cardiac arrest patients: a feasibility study. Scandinavian journal of trauma resuscitation and emergency medicine 2014; 29: 22: 70. doi: 10.1186/s13049- 014-0070-2
  • 6. Nguyen HB, Huang DT, Pinsky MR. Hemodynamic monitoring. In: Tintinalli JE, Stapczynski JS, Ma OJ, Yealy D, Meckler GD et al. (editors). Tintinalli’s Emergency Medicine: A Comprehensive Study Guide 8th ed. United States, US: McGraw-Hill Education; 2016. pp. 216.
  • 7. Entholzner E, Felber A, Mielke L, Hargasser S, Breinbauer B et al. The determination of end-expiratory CO2 during resuscitation. Experience and results with the Normocap 200 (Fa. Datex) in preclinical resuscitation conditions. Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie 1992; 27(8): 473-476 (in German). doi: 10.1055/s-2007-1000341
  • 8. Garnett AR, Ornato JP, Gonzalez ER, Johnson EB. Endtidal carbon dioxide monitoring during cardiopulmonary resuscitation. JAMA 1987; 257(4): 512-515.
  • 9. Bhende MS, Karasic DG, Karasic RB. End-tidal carbon dioxide changes during cardiopulmonary resuscitation after experimental asphyxial cardiac arrest. American journal of emergency medicine 1996; 14(4): 349-350. doi: 10.1016/S0735- 6757(96)90046-7
  • 10. Prause G, Hetz H, Lauda P, Pojer H, Smolle-Juettner F et al. A comparison of the end-tidal-CO2 documented by capnometry and the arterial pCO2 in emergency patients. Resuscitation 1997; 35(2): 145-148.
  • 11. Belpomme V, Ricard-Hibon A, Devoir C, Dileseigres S, Devaud ML et al. Correlation of arterial PCO2 and PETCO2 in prehospital controlled ventilation. American journal of emergency medicine 2005; 23(7): 852-859. doi: 10.1016/j. ajem.2005.04.011
  • 12. Spindelboeck W, Gemes G, Strasser C, Toescher K, Kores B et al. Arterial blood gases during and their dynamic changes after cardiopulmonary resuscitation: a prospective clinical study. Resuscitation 2016; 106: 24–29. doi: 10.1016/j. resuscitation.2016.06.013
  • 13. Hope Kilgannon J, Hunter BR, Puskarich MA, Shea L, Fuller B et al. Partial pressure of arterial carbon dioxide after resuscitation from cardiac arrest and neurological outcome: A prospective multi-center protocol-directed cohort study. Resuscitation 2019 Feb; 135: 212-220. doi: 10.1016/j. resuscitation.2018.11.015
APA calbay a, ÇAKIR Z, BAYRAMOGLU A (2019). Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. , 1298 - 1302. 10.3906/sag-1812-156
Chicago calbay ayca,ÇAKIR Zeynep,BAYRAMOGLU ATIF Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. (2019): 1298 - 1302. 10.3906/sag-1812-156
MLA calbay ayca,ÇAKIR Zeynep,BAYRAMOGLU ATIF Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. , 2019, ss.1298 - 1302. 10.3906/sag-1812-156
AMA calbay a,ÇAKIR Z,BAYRAMOGLU A Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. . 2019; 1298 - 1302. 10.3906/sag-1812-156
Vancouver calbay a,ÇAKIR Z,BAYRAMOGLU A Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. . 2019; 1298 - 1302. 10.3906/sag-1812-156
IEEE calbay a,ÇAKIR Z,BAYRAMOGLU A "Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients." , ss.1298 - 1302, 2019. 10.3906/sag-1812-156
ISNAD calbay, ayca vd. "Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients". (2019), 1298-1302. https://doi.org/10.3906/sag-1812-156
APA calbay a, ÇAKIR Z, BAYRAMOGLU A (2019). Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. Turkish Journal of Medical Sciences, 49(5), 1298 - 1302. 10.3906/sag-1812-156
Chicago calbay ayca,ÇAKIR Zeynep,BAYRAMOGLU ATIF Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. Turkish Journal of Medical Sciences 49, no.5 (2019): 1298 - 1302. 10.3906/sag-1812-156
MLA calbay ayca,ÇAKIR Zeynep,BAYRAMOGLU ATIF Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. Turkish Journal of Medical Sciences, vol.49, no.5, 2019, ss.1298 - 1302. 10.3906/sag-1812-156
AMA calbay a,ÇAKIR Z,BAYRAMOGLU A Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. Turkish Journal of Medical Sciences. 2019; 49(5): 1298 - 1302. 10.3906/sag-1812-156
Vancouver calbay a,ÇAKIR Z,BAYRAMOGLU A Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients. Turkish Journal of Medical Sciences. 2019; 49(5): 1298 - 1302. 10.3906/sag-1812-156
IEEE calbay a,ÇAKIR Z,BAYRAMOGLU A "Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients." Turkish Journal of Medical Sciences, 49, ss.1298 - 1302, 2019. 10.3906/sag-1812-156
ISNAD calbay, ayca vd. "Prognostic value of blood gas parameters and end-tidal carbon dioxide values in out-of-hospital cardiopulmonary arrest patients". Turkish Journal of Medical Sciences 49/5 (2019), 1298-1302. https://doi.org/10.3906/sag-1812-156