Expired end-tidal carbon dioxide (PCO2) measurements made during cardiopulmonary resuscitation have correlated with cardiac output and coronary perfusion pressure when wide ranges of blood flow are included. The utility of such measurements for predicting resuscitation outcome during the low flow state associated with closed chest cardiopulmonary resuscitation remains uncertain. Expired end-tidal PCO2 and coronary perfusion pressures were measured in 15 mongrel dogs undergoing 15 min of closed chest cardiopulmonary resuscitation after a 3 min period of untreated ventricular fibrillation. In six successfully resuscitated dogs, the mean expired end-tidal PCO2 was significantly higher than that in nine nonresuscitated dogs only after 14 min of cardiopulmonary resuscitation (6.2 ± 1.2 versus 3.4 ± 0.8 mmHg; p < 0.05). No differences in expired end-tidal PCO2 values were found at 2, 7 or 12 min of cardiopulmonary resuscitation. A significant decline in end-tidal PCO2 levels during the resuscitation effort was seen in the nonresuscitated group (from 6.3 ± 0.8 to 3.4 ± 0.8 mmHg; p < 0.05); while the successfully resuscitated group had constant PCO2 levels throughout the 15 min of cardiac arrest (ranging from 6.8 ± 1.1 to 6.2 ± 1.2 mmHg). Changes in expired PCO2 levels during cardiopulmonary resuscitation may be a useful noninvasive predictor of successful resuscitation and survival from cardiac arrest.


This is the author accepted manuscript of Kern, K.B., Sanders, A.B., Voorhees, W.D., Babbs, C.F., Tacker, W.A., Ewy, G.A., Changes in expired end-tidal carbon dioxide during cardiopulmonary resuscitation in dogs: a prognostic guide for cardiopulmonary resuscitation efforts, Journal of the American College of Cardiology 13, 1184-1189, 1989. Copyright Elsevier, it is made available here CC-BY-NC-ND, and the version of record can be found here: https://doi.org/10.1016/0735-1097(89)90282-9.

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