• Resuscitation · May 2020

    Randomized Controlled Trial

    Modified volumetric capnography-derived parameter: A potentially stable indicator in monitoring cardiopulmonary resuscitation efficacy in a porcine model.

    • Jun Xu, Xuezhong Yu, Lili Zhang, Yangyang Fu, Kui Jin, Lu Yin, Shanshan Yu, and Danyu Liu.
    • Emergency Department, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. Electronic address: xujunfree@126.com.
    • Resuscitation. 2020 May 1; 150: 94-101.

    AimWe aimed to investigate whether the ability of the volumetric capnography-derived parameter, the volume of CO2 eliminated per minute and per kg body weight (V'CO2 kg-1), in monitoring the quality of CPR and predicting the return of spontaneous circulation (ROSC) remains undisturbed by hyperventilation.MethodsThis randomised crossover study included 12 male domestic pigs. After 4 min of untreated ventricular fibrillation, mechanical CPR was administered. Following 5-min washout periods, each animal underwent two sessions of experiments; four 5-min ventilation trials followed by advanced life support, consecutively in the two sessions.ResultsDifferent ventilation types had no significant impact on V'CO2 kg-1 or haemodynamics. However, PETCO2 was significantly affected by the ventilation type and coronary perfusion pressure (P < 0.05). The means ± standard deviations of PETCO2 decreased linearly with an increase in the respiratory rate (RR) (P < 0.05). The PETCO2 decreased from 20.42 ± 9.51 to 16.16 ± 5.07 (P < 0.05) as the tidal volume increased from 10 to 20 mL min-1. No significant differences in V'CO2 kg-1 were observed between the three RR levels of ventilation types (P = 0.274). Post hoc analysis demonstrated a significant difference between the highest value of V'CO2 kg-1 in double tidal volume hyperventilation and normal ventilation and triple respiratory rate hyperventilation (P < 0.05). The AUC for V'CO2 kg-1 and PETCO2 in discriminating between survivors and non-survivors was 0.80 and 0.71, respectively.ConclusionsV'CO2 kg-1 performs better than PETCO2 in monitoring the quality of CPR during hyperventilation. In predicting ROSC during variations in a ventilation state, V'CO2 kg-1 has good predictive ability.Copyright © 2020 Elsevier B.V. All rights reserved.

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