Abstract
Purpose
Basing on the relationship between the quality of cardiopulmonary resuscitation (CPR)
and the responsiveness of VF to the defibrillation we aimed to assess whether the
values of ETCO2 in the minute before defibrillation could predict the effectiveness
of the shock.
Materials and methods
We retrospectively evaluated the reports generated by the manual monitor/defibrillator
(Corpuls by GS Elektromedizinische Geräte G. Stemple GmbH, Germany) used for cases
of VF cardiac arrest from January 2015 to December 2016. The mean ETCO2 value of the
minute preceding the shock (METCO260) was computed. A blind evaluation of the effectiveness of each shock was provided
by three cardiologists.
Results
A total amount of 207 shocks were delivered for 62 patients. When considering the
three tertiles of METCO260 (T1:METCO260 ≤ 20 mmHg; T2: 20 mmHg < METCO260 ≤ 31 mmHg and T3: METCO260 > 31 mmHg) a statistically significant difference between the percentages of shock success
was found (T1: 50%; T2: 63%; T3: 78%; Chi square p = 0.003; p for trend <0.001). When the METCO260 was lower than 7 mmHg no shock was effective and when the METCO260 was higher than 45 mmHg no shock was ineffective. Shocks followed by ROSC were preceded by higher values
of METCO260 as compared either to ineffective shocks or effective ones without ROSC.
Conclusions
This is the first demonstration of the relation between ETCO2 and defibrillation effectiveness.
Our findings stress the pivotal role of High Quality CPR, monitored via ETCO2, and
suggest ETCO2 monitoring as an additional weapon to guide defibrillation.
Keywords
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Article info
Publication history
Published online: September 20, 2017
Accepted:
September 14,
2017
Received in revised form:
September 2,
2017
Received:
July 24,
2017
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2017.09.010.
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
