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EMCrit Podcast 208 – Felipe Teran on Why We are Doing CPR Wrong

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lunes, 14 de marzo de 2016

ETCO2 and Trauma Mortality

March 3, 2016 - By Chase Doyle 
“Our results suggest that end-tidal carbon dioxide is a valuable short-term prognostic indicator in trauma patients underdoing emergency surgery,” said Danielle K. Bodzin, MD, an anesthesiologist at University of Miami/Jackson Memorial Medical Center. “We suggest that continuous end-tidal carbon dioxide monitoring early on in the resuscitation bay and during transport prior to entering the operating room [OR] could be a very useful practical marker of successful resuscitation, and may help us determine which trauma patients might benefit from early, aggressive resuscitation...
The researchers, who presented their findings at the 2015 annual meeting of the American Society of Anesthesiologists (abstract 5007), concluded that ETCO2 of less than or equal to 20 mm Hg was highly predictive of mortality.
As the number of end-tidal carbon dioxide gets lower,” Dr. Bodzin said, “it’s even more predictive of intraoperative cardiac arrest or death.” For example, ETCO2sustained below 15 mm Hg for five minutes is a 98.9% specific predictor of cardiac arrest or death. An ETCO2 sustained less than 10 mm Hg for five minutes is a 99.6% predictor of mortality.
ETCO2 is a surrogate measure of cardiac output that can reflect sudden change. Dr. Bodzin said it can help gauge the adequacy of resuscitation during nontraumatic cardiac arrest."