|Title||End-tidal carbon dioxide during pediatric in-hospital cardiopulmonary resuscitation.|
|Publication Type||Journal Article|
|Year of Publication||2018|
|Authors||Berg, RA, Reeder, RW, Meert, KL, Yates, AR, Berger, JT, Newth, CJ, Carcillo, JA, McQuillen, PS, Harrison, RE, Moler, FW, Pollack, MM, Carpenter, TC, Notterman, DA, Holubkov, R, J Dean, M, Nadkarni, VM, Sutton, RM|
|Date Published||2018 Aug 15|
BACKGROUND: Based on laboratory cardiopulmonary resuscitation (CPR) investigations and limited adult data, the American Heart Association Consensus Statement on CPR Quality recommends titrating CPR performance to achieve end-tidal carbon dioxide (ETCO2) >20 mmHg.
AIMS: We prospectively evaluated whether ETCO2 > 20 mmHg during CPR was associated with survival to hospital discharge.
METHODS: Children ≥37 weeks gestation in Collaborative Pediatric Critical Care Research Network intensive care units with chest compressions for ≥1 min and ETCO2 monitoring prior to and during CPR between July 1, 2013 and June 31, 2016 were included. ETCO2 and Utstein-style cardiac arrest data were collected. Multivariable Poisson regression models with robust error estimates were used to estimate relative risk of outcomes.
RESULTS: Blinded investigators analyzed ETCO2 waveforms from 43 children. During CPR, the median ETCO2 was 23 mmHg [quartiles, 16 and 28 mmHg], median ventilation rate was 29 breaths/min [quartiles, 24 and 35 breaths/min], and median duration of CPR was 5 min [quartiles, 2 and 16 min]. Return of spontaneous circulation occurred after 71% of CPR events and 37% of patients survived to hospital discharge. For children with mean ETCO2 during CPR > 20 mmHg, the adjusted relative risk for survival was 0.92 (0.41, 2.08), p = 0.84. The median mean ETCO2 among children who survived to hospital discharge was 20 mmHg [quartiles; 15, 28 mmHg] versus 23 mmHg [16, 28 mmHg] among non-survivors.
CONCLUSION: Mean ETCO2 > 20 mmHg during pediatric in-hospital CPR was not associated with survival to hospital discharge, and ETCO2 was not different in survivors versus non-survivors.
|Grant List||U10 HD063108 / HD / NICHD NIH HHS / United States |
U10 HD050012 / HD / NICHD NIH HHS / United States
UG1 HD049983 / HD / NICHD NIH HHS / United States
UG1 HD050096 / HD / NICHD NIH HHS / United States
UG1 HD063108 / HD / NICHD NIH HHS / United States
U10 HD063114 / HD / NICHD NIH HHS / United States
U01 HD049934 / HD / NICHD NIH HHS / United States
UG1 HD049981 / HD / NICHD NIH HHS / United States