Critical Care

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Commentary

Capnography during cardiac resuscitation: a clue on mechanisms and a guide to interventions

Raúl J Gazmuri1* and Erika Kube2

Author Affiliations

1 Professor of Medicine and Associate Professor of Physiology & Biophysics, Department of Medicine, Division of Critical Care and Department of Physiology & Biophysics, Finch University of Health Sciences/The Chicago Medical School, and Medical Service, Section of Critical Care Medicine, North Chicago VA Medical Center, North Chicago, Illinois, USA

2 Medical student, Finch University of Health Sciences/The Chicago Medical School, Chicago, Illinois, USA

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Critical Care 2003, 7:411-412 doi:10.1186/cc2385

Published: 6 October 2003

Abstract

Measurement of the end-tidal partial pressure of carbon dioxide (PETCO2) during cardiac arrest has been shown to reflect the blood flow being generated by external means and to prognosticate outcome. In the present issue of Critical Care, Grmec and colleagues compared the initial and subsequent PETCO2 in patients who had cardiac arrest precipitated by either asphyxia or ventricular arrhythmia. A much higher PETCO2 was found immediately after intubation in instances of asphyxial arrest. Yet, after 1 min of closed-chest resuscitation, both groups had essentially the same PETCO2, with higher levels in patients who eventually regained spontaneous circulation. The Grmec and colleagues' study serves to remind us that capnography can be used during cardiac resuscitation to assess the mechanism of arrest and to help optimize the forward blood flow generated by external means.

Keywords:
arrhythmias; asphyxia; capnography; cardiac arrest; prognosis; resuscitation