End-Tidal Carbon Dioxide During Out-of-Hospital Cardiac Arrest Resuscitation: Comparison of Active Compression-Decompression and Standard CPR, , ,

Study objectives: To compare the maximal end-tidal carbon dioxide pressure (ETCO2 peak) values obtained during standard (S-CPR) and active compression-decompression CPR (ACD-CPR) during prolonged resuscitation in out-of-hospital cardiac arrest. Design: Prospective, randomized crossover study. Setting: City with a population of 3.5 million, served by an emergency medical service system providing advanced cardiac life support. Participants: Patients with nontraumatic out-of-hospital cardiac arrest. Interventions: Patients were randomly assigned to receive first, for a period of 3 minutes, either ACD-CPR or S-CPR; then the two methods were alternated. ETCO2 was continuously monitored and computed. Measurements and Results: Sixteen patients (48±20 years old) were included; in 12, return of spontaneous circulation was achieved, and 5 were admitted alive to the hospital. A statistically significant increase in ETCO2 peak was obtained with ACD-CPR (27.6±3 mm Hg) compared with S-CPR (15.6±2.2 mm Hg). No major adverse effect possibly related to ACD-CPR was observed. Conclusion: This prospective study suggests that ACD-CPR may improve cardiac output compared with S-CPR. [Orliaguet GA, Carli PA, Rozenberg A, Janniere D, Sauval P, Delpech P: End-tidal carbon dioxide during out-of-hospital cardiac arrest resuscitation: Comparison of active compression-decompression and standard CPR. Ann Emerg Med January 1995;25:48-51.]