Clinical Analysis of PetCO2 in Predicting Abdominal Lifting and Compression CPR

Abstract

Objective: To analyse clinical effect of partial pressure of end-tidal carbon dioxide (PetCO 2 ) in evaluating and predicting abdominal lifting and compression CPR(ALP-CPR).Methods: 92 patient of cardiac arrest were in tubated and received ALP-CPR performed with a novel abdominal lifting/compression device by monitoring HR, PaO 2 , PaCO 2 and PetCO 2 according to the ultimate outcome of CPR, patients were divided into success group and failure group, the number of patients with 30min and 60min survival and the time of ROSC were recorded in successful group, and calculated the recovery success rate. Data according to the Utstein criteria, demographic information, medical data. we hypothesized that an PetCO 2 level of 2.67kPa (20mmHg) or more after 20 minutes of standard advanced cardiac life support would predict ROSC.Results: At beginning of ALP-CPR, PetCO 2 of both groups were about 9 10mmHg. PetCO 2 was gradually rising in successful group during ALP-CPR process and increased slightly at 2~5min after ALP-CPR, then progressively decreased in failure group(P<0.05). PetCO 2 values of 2.67kPa (20mmHg) or less discriminated between 37patients with ROSC and 55 patients without (P<0.05), but the successful recovery rate at 60 min after ROSC was 17.4% (16/92) in successful group. The difference of MAP, PaO 2 and PaCO 2 after ROSC 20min compared with abdominal lifting and compression CPR process was statistically significant (P<0.05), area under the receiver operating characteristic curve(95%CI) is 0.845, the sensitivity and specificity were respectively 0.80,0.83. Conclusions:The variation of PetCO 2 value can be used as a clinical index to evaluate and predict the effect of ALP-CPR, and PetCO 2 levels of more than 2.67kPa (20mmHg) after 20 minutes may be used to predict ROSC. The ROSC time is positive correlation with the ROSC rate.