Open AccessCapnography during cardiopulmonary resuscitation: Current evidence and future directions
Author(s) -
Bhavani Shankar Kodali,
Richard D. Urman
Publication year - 2014
Publication title -
journal of emergencies, trauma and shock
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.313
H-Index - 29
eISSN - 0974-519X
pISSN - 0974-2700
DOI - 10.4103/0974-2700.142778
Subject(s) - capnography , medicine , cardiopulmonary resuscitation , return of spontaneous circulation , intensive care medicine , life support , resuscitation , advanced life support , intensive care , anesthesia , cardiology
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.