Background/aim: This study aimed to evaluate the usefulness of blood gas and end-tidal carbon dioxide (EtCO 2) measurements for predicting 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 was evaluated after 1 h at ROSC and at hospital discharge, as defined by the cerebral performance category score. The blood gas parameters pH, PO 2 , PCO 2, lactate, and BE were compared with EtCO 2 from capnography and arteriol/alveolar carbon dioxide difference (AaDCO 2) 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 PO 2 , PCO 2, and AaDCO 2 values showed a prognostic marker for the supply of ROSC (P < 0.05). The EtCO 2 , lactate, and BE values measured by the blood gas were found to be insignificant in the prediction of ROSC (P > 0.05). Conversely, AaDCO 2 was found to be significant in ROSC estimation (P < 0.05), but not in neurological evaluation (P > 0.05). Conclusion: Blood gas parameters and EtCO 2 are sufficient in predicting ROSC. The value of AaDCO 2 calculated using EtCO 2 and PO 2 may be used in predicting the prognosis of OHCA patients, but this value does not provide any conclusions concerning neurological survival.

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A 77-year-old female patient presented to EU with abdominal pain, nausea, vomiting, constipation, and abdominal distention. The patient's vital signs were in the normal range. Based on her physical examination, there was abdominal distention and general abdominal tenderness in all quadrants, especially on the right upper side, with palpation. Other system examinations were normal. She underwent a hysterectomy operation 1 year ago. Patient's routine blood tests and kidney and liver function tests were in the normal range. Intestinal-type air-fluid level (Figure 1) was seen on direct abdominal radiography. Abdominal CT showed a gall stone, with free air around the stone, and PCI was obvious on the intestinal wall (Figure 2a, b). The patient underwent general surgery consultation. Surgeons suggested operation, but she rejected the suggestion. Thus, she underwent supportive therapy. The patient's clinical condition degraded and she was discharged on the third day of hospitalization in the surgery service.