Monitoring of PETCO2 and CO levels in patients with cardiac arrest and their value in assessing resuscitation outcomes

Yu Meijun; Wang Qiuyan; Wang Xiaolei

doi:10.3969/j.issn.1674-3245.2025.01.015

Abstract：Objective To analyze the relationship between end-expiratory partial pressure of carbon dioxide(PetCO2)and cardiac output in patients with cardiac arrest and its predictive value for the outcome of cardiopulmonary resuscitation.Methods A prospective study was conducted on 107 patients with cardiac arrest admitted to the Department of Emergency and Critical Care(ICU)of Qinhuangdao Hospital,Peking University Third Hospital from October 2021 to October 2023.Patients were divided into the ROSC group(n=90)and non-ROSC group(n=17)according to the return of spontaneous circulation(ROSC)situation,and also into the successful cardiopulmonary resuscitation group(n=100)and the failed group(n=7)based on the success of cardiopulmonary resuscitation.PetCO2 and cardiac output(CO)were compared between the ROSC group and non-ROSC group,and between the successful and failed cardiopulmonary resuscitation groups at different time periods(beginning of cardiopulmonary resuscitation,10-min resuscitation,20-min resuscitation,30-min resuscitation,6-h resuscitation).Pearson correlation analysis was performed to analyze the correlation between PetCO2 and CO,and the receiver-operating characteristic(ROC)curve was plotted to analyze the predictive efficacy of PetCO2 and CO on cardiopulmonary resuscitation failure.Results At 10-min,20-min,30-min,and 6-h resuscitation,the PetCO2 and CO levels in the ROSC group were significantly higher than those in the non-ROSC group(t=3.080,2.758,7.236,4.361,5.395,11.662,7.978 and 4.827,respectively;P<0.05).At 10-min,20-min,30-min,and 6-h resuscitation,the PetCO2 and CO levels in the successful cardiopulmonary resuscitation group were significantly higher than those in the failed group(t=3.843,2.744,5.005,4.147,5.395,11.662,2.948,2.454,respectively;P<0.05).PetCO2 and CO were positively correlated(r=0.392,P<0.01).The AUC of PetCO2 and CO combined monitoring to predict cardiopulmonary resuscitation failure was 0.906,and the 95%CI confidence interval was 0.859～0.952.The sensitivity(95.12%)and specificity(92.28%)of PetCO2 and CO combined monitoring were higher than those of single monitoring.Conclusion PetCO2 and CO in patients with cardiac arrest are positively correlated.The combined monitoring of PetCO2 and CO can improve the prediction efficiency of cardiopulmonary resuscitation outcome,which has certain reference value.