Kin Ming Poon1, Chun Tat Lui2, Kwok Leung Tsui3. 1. Pok Oi Hospital, Hong Kong. 2. Tuen Mun Hospital, Hong Kong. Electronic address: ectlui@yahoo.com.hk. 3. Tuen Mun Hospital, Hong Kong.
Abstract
OBJECTIVE: To evaluate the role of initial ETCO2 value in prognostication of OHCA patients in an Asian-Chinese cohort. DESIGN: Prospective cohort study. SETTING: Emergency departments of two regional hospitals in a cluster of Hong Kong. PATIENTS: Patients were recruited prospectively from the local cardiac arrest registry from July 2012 to June 2013. Patients of non traumatic OHCA aged ≥18 years old were included. Patients of OHCA presented with postmortem changes, those who decided for Do Not Resuscitate (DNR), regained pulse before arrival, or those without proper documentation of ETCO2 would be excluded. OUTCOME: Primary outcome was return of spontaneous circulation (ROSC). RESULTS: A 3-min ETCO2 >10mmHg was a predictor of ROSC with OR 18.16 (95% CI 4.79-51.32, p<0.001). The diagnostic accuracy of 3-min ETCO2 >10mmHg to predict ROSC: sensitivity was 0.95 (95% CI 0.89-0.98) while the specificity was 0.27 (95% CI 0.21-0.33). Positive predictive value was 0.40 (95% CI 0.34-0.46) while negative predictive value (NPV) was 0.92 (95% CI 0.82-0.97). Area under ROC curve of 3-min ETCO2 predicting ROSC was 0.80 (95% CI 0.71-0.91). CONCLUSIONS: A 3-min ETCO2 ≤10mmHg was associated with poor prognosis and low chance of ROSC. Low ETCO2 level may have a role to reduce prolonged medically futile resuscitation.
OBJECTIVE: To evaluate the role of initial ETCO2 value in prognostication of OHCA patients in an Asian-Chinese cohort. DESIGN: Prospective cohort study. SETTING: Emergency departments of two regional hospitals in a cluster of Hong Kong. PATIENTS: Patients were recruited prospectively from the local cardiac arrest registry from July 2012 to June 2013. Patients of non traumatic OHCA aged ≥18 years old were included. Patients of OHCA presented with postmortem changes, those who decided for Do Not Resuscitate (DNR), regained pulse before arrival, or those without proper documentation of ETCO2 would be excluded. OUTCOME: Primary outcome was return of spontaneous circulation (ROSC). RESULTS: A 3-min ETCO2 >10mmHg was a predictor of ROSC with OR 18.16 (95% CI 4.79-51.32, p<0.001). The diagnostic accuracy of 3-min ETCO2 >10mmHg to predict ROSC: sensitivity was 0.95 (95% CI 0.89-0.98) while the specificity was 0.27 (95% CI 0.21-0.33). Positive predictive value was 0.40 (95% CI 0.34-0.46) while negative predictive value (NPV) was 0.92 (95% CI 0.82-0.97). Area under ROC curve of 3-min ETCO2 predicting ROSC was 0.80 (95% CI 0.71-0.91). CONCLUSIONS: A 3-min ETCO2 ≤10mmHg was associated with poor prognosis and low chance of ROSC. Low ETCO2 level may have a role to reduce prolonged medically futile resuscitation.
Authors: Jose Julio Gutiérrez; Mikel Leturiondo; Sofía Ruiz de Gauna; Jesus María Ruiz; Izaskun Azcarate; Digna María González-Otero; Juan Francisco Urtusagasti; James Knox Russell; Mohamud Ramzan Daya Journal: PLoS One Date: 2021-05-18 Impact factor: 3.240
Authors: Jose Julio Gutiérrez; Jesus María Ruiz; Sofía Ruiz de Gauna; Digna María González-Otero; Mikel Leturiondo; James Knox Russell; Carlos Corcuera; Juan Francisco Urtusagasti; Mohamud Ramzan Daya Journal: PLoS One Date: 2020-02-05 Impact factor: 3.240
Authors: Jasmeet Soar; Katherine M Berg; Lars W Andersen; Bernd W Böttiger; Sofia Cacciola; Clifton W Callaway; Keith Couper; Tobias Cronberg; Sonia D'Arrigo; Charles D Deakin; Michael W Donnino; Ian R Drennan; Asger Granfeldt; Cornelia W E Hoedemaekers; Mathias J Holmberg; Cindy H Hsu; Marlijn Kamps; Szymon Musiol; Kevin J Nation; Robert W Neumar; Tonia Nicholson; Brian J O'Neil; Quentin Otto; Edison Ferreira de Paiva; Michael J A Parr; Joshua C Reynolds; Claudio Sandroni; Barnaby R Scholefield; Markus B Skrifvars; Tzong-Luen Wang; Wolfgang A Wetsch; Joyce Yeung; Peter T Morley; Laurie J Morrison; Michelle Welsford; Mary Fran Hazinski; Jerry P Nolan Journal: Resuscitation Date: 2020-10-21 Impact factor: 5.262