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A. Randolph Garnett, MD; Joseph P. Ornato, MD; Edgar R. Gonzalez, PharmD; E. Bruce Johnson, MD

JAMA. 1987;257(4):512-515.

Abstract
The end-tidal carbon dioxide (CO₂) concentration has been found to correlate with cardiac output during and after cardiopulmonary resuscitation (CPR) in animal models. We monitored end-tidal CO₂ values continuously during cardiac resuscitation in 23 humans while ventilation was held constant with a computercontrolled CPR Thumper. This report focuses on ten of the 23 patients who experienced return of spontaneous circulation (ROSC) during monitoring. There was no significant difference in the end-tidal CO₂ value of patients without ROSC (1.8% ±0.9%) and the end-tidal CO₂ value of patients before ROSC in patients who had ROSC (1.7%± ±0.6%). The end-tidal CO₂ concentration increased immediately in all patients who had ROSC, from 1.7% ±0.6% to 4.6% ±1.4%, then gradually returned to a new baseline (3.1% ± 0.9%). Change in the end-tidal CO₂ value was often the first clinical indicator that ROSC had occurred. Our findings suggest that end-tidal CO₂ monitoring may provide clinically useful information that can be used to guide therapy during CPR.

(JAMA 1987;257:512-515)

Author Affiliations
From the Pulmonary (Dr Garnett) and Cardiology (Dr Ornato) Sections, Department of Internal Medicine, and the Departments of Pharmacy (Dr Gonzalez) and Anesthesiology (Dr Johnson), Medical College of Virginia, Richmond.

Footnotes
Reprint requests to Box 525, Medical College of Virginia, Richmond, VA 23298 (Dr Garnett).

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