Abstract:
INTRODUCTION:Prognosis in patients suffering out-of-hospital cardiac arrest is poor. Higher survival rates have been observed only in patients with ventricular fibrillation who were fortunate enough to have basic and advanced life support initiated soon after cardiac arrest. An ability to predict cardiac arrest outcomes would be useful for resuscitation. Changes in expired end-tidal carbon dioxide levels during cardiopulmonary resuscitation (CPR) may be a useful, noninvasive predictor of successful resuscitation and survival from cardiac arrest, and could help in determining when to cease CPR efforts. METHODS:This is a prospective, observational study of 737 cases of out-of-hospital cardiac arrest. The patients were intubated and measurements of end-tidal carbon dioxide taken. Data according to the Utstein criteria, demographic information, medical data, and partial pressure of end-tidal carbon dioxide (PetCO2) values were collected for each patient in cardiac arrest by the emergency physician. We hypothesized that an end-tidal carbon dioxide level of 1.9 kPa (14.3 mmHg) or more after 20 minutes of standard advanced cardiac life support would predict restoration of spontaneous circulation (ROSC). RESULTS:PetCO2 after 20 minutes of advanced life support averaged 0.92 +/- 0.29 kPa (6.9 +/- 2.2 mmHg) in patients who did not have ROSC and 4.36 +/- 1.11 kPa (32.8 +/- 9.1 mmHg) in those who did (P < 0.001). End-tidal carbon dioxide values of 1.9 kPa (14.3 mmHg) or less discriminated between the 402 patients with ROSC and 335 patients without. When a 20-minute end-tidal carbon dioxide value of 1.9 kPa (14.3 mmHg) or less was used as a screening test to predict ROSC, the sensitivity, specificity, positive predictive value, and negative predictive value were all 100%. CONCLUSIONS:End-tidal carbon dioxide levels of more than 1.9 kPa (14.3 mmHg) after 20 minutes may be used to predict ROSC with accuracy. End-tidal carbon dioxide levels should be monitored during CPR and considered a useful prognostic value for determining the outcome of resuscitative efforts and when to cease CPR in the field.
journal_name
Crit Carejournal_title
Critical care (London, England)authors
Kolar M,Krizmaric M,Klemen P,Grmec Sdoi
10.1186/cc7009subject
Has Abstractpub_date
2008-01-01 00:00:00pages
R115issue
5eissn
1364-8535issn
1466-609Xpii
cc7009journal_volume
12pub_type
杂志文章相关文献
CRITICAL CARE文献大全abstract::Hemodynamic monitoring is a central component of intensive care. Patterns of hemodynamic variables often suggest cardiogenic, hypovolemic, obstructive, or distributive (septic) etiologies to cardiovascular insufficiency, thus defining the specific treatments required. Monitoring increases in invasiveness, as required,...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc3927
更新日期:2005-01-01 00:00:00
abstract::Cardiogenic shock is a lethal condition. Physicians are searching for hemodynamic markers which could help risk-stratification of patients in this picture. Torgersen and coworkers present an hourly time integral of the cardiac power index and cardiac index drops to predict outcomes in the setting of cardiogenic shock....
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc8176
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Patients admitted to the intensive care unit often develop hyperglycaemia, but the underlying mechanisms have not been fully described. The incretin effect is reduced in patients with type 2 diabetes. Type 2 diabetes and critical illness have phenotypical similarities, such as hyperglycaemia, insulin resis...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-1118-z
更新日期:2015-11-16 00:00:00
abstract:BACKGROUND:Patients with COVID-19 (COVID) may develop acute respiratory distress syndrome with or without sepsis, coagulopathy and visceral damage. While chest CT scans are routinely performed in the initial assessment of patients with severe pulmonary forms, thymus involvement and reactivation have not been investigat...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-03440-1
更新日期:2021-01-04 00:00:00
abstract:INTRODUCTION:Cardio-renal syndromes are characterized by the impairment of cardiac and renal functions. Plasma and urinary neutrophil gelatinase-associated lipocalin (NGAL), and plasma B-type natriuretic peptide (BNP) are markers of acute kidney injury (AKI) and heart failure (HF), respectively. METHODS:GFR (99mTc-DTP...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc13752
更新日期:2014-02-28 00:00:00
abstract::An influenza pandemic threatens to be the most lethal public health crisis to confront the world. Physicians will have critical roles in diagnosis, containment and treatment of influenza, and their commitment to treat despite increased personal risks is essential for a successful public health response. The obligation...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc6918
更新日期:2008-01-01 00:00:00
abstract::Even more than in previous disasters, Katrina has proven itself to be a testing ground for a plethora of new technologies. Although not all of these technologies did immediately save lives, in this regard a number of them exhibited considerable potential for the future, and hence there is a need to include them in fut...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc3945
更新日期:2006-02-01 00:00:00
abstract::Platelet transfusions carry greater risks of infection, sepsis, and death than any other blood product, owing primarily to bacterial contamination. Many patients may be at particular risk, including critically ill patients in the intensive care unit. This narrative review provides an overview of the problem and an upd...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-018-2212-9
更新日期:2018-10-27 00:00:00
abstract:INTRODUCTION:The performance of N-terminal pro-brain natriuretic peptide (NT-proBNP) and C-reactive protein (CRP) to predict clinical outcomes in ICU patients is unimpressive. We aimed to assess the prognostic value of NT-proBNP, CRP or the combination of both in unselected medical ICU patients. METHODS:A total of 576...
journal_title:Critical care (London, England)
pub_type: 临床试验,杂志文章
doi:10.1186/cc10004
更新日期:2011-01-01 00:00:00
abstract:: ...
journal_title:Critical care (London, England)
pub_type: 社论
doi:10.1186/s13054-018-2203-x
更新日期:2018-11-03 00:00:00
abstract:INTRODUCTION:Sepsis is characterized by systemic microvascular dysfunction. Endothelial progenitor cells (EPCs) are critically involved in maintaining vascular homeostasis under both physiological and pathological conditions. The aim of the present study was to analyze the endothelial progenitor cell system in patients...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10100
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:The aim of this study was to assess the effect of low-dose corticosteroid therapy in reducing shock duration after severe burn. METHODS:A placebo-controlled, double-blind, randomized clinical trial (RCT) was performed on two parallel groups in the burn intensive care unit (ICU). Patients were randomized t...
journal_title:Critical care (London, England)
pub_type: 杂志文章,随机对照试验
doi:10.1186/s13054-015-0740-0
更新日期:2015-01-26 00:00:00
abstract::Antithrombotic prophylaxis in critically ill patients frequently fails. Venous thromboembolism is associated with adverse clinical outcomes, including a prolonged intensive care unit stay and death. A potential mechanism by which critically ill patients may be predisposed to antithrombotic failure is the inability to ...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章,评审
doi:10.1186/cc4978
更新日期:2006-01-01 00:00:00
abstract::In sepsis, inflammation and thrombosis are both the cause and the result of interactions between circulating (for example, leukocytes and platelets), endothelial and smooth muscle cells. Microparticles are proinflammatory and procoagulant fragments originating from plasma membrane generated after cellular activation a...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/cc9231
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Coronavirus disease 2019 (COVID-19) has become a public health emergency of global concern. We aimed to explore the risk factors of 14-day and 28-day mortality and develop a model for predicting 14-day and 28-day survival probability among adult hospitalized patients with COVID-19. METHODS:In this multicent...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/s13054-020-03123-x
更新日期:2020-07-16 00:00:00
abstract:INTRODUCTION:There is a need for continuous glucose monitoring in critically ill patients. The objective of this trial was to determine the point accuracy and reliability of a device designed for continuous monitoring of interstitial glucose levels in intensive care unit patients. METHODS:We evaluated point accuracy b...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-0757-4
更新日期:2015-02-05 00:00:00
abstract::Coronavirus disease (COVID-19) is an emerging viral infection that is rapidly spreading across the globe. SARS-CoV-2 belongs to the same coronavirus class that caused respiratory illnesses such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS). During the SARS and MERS outbreaks, ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-020-03231-8
更新日期:2020-09-23 00:00:00
abstract::Certain noble gases, though inert, exhibit remarkable biological properties. Notably, xenon and argon provide neuroprotection in animal models of central nervous system injury. In the previous issue of Critical Care, Loetscher and colleagues provided further evidence that argon may have therapeutic properties for neur...
journal_title:Critical care (London, England)
pub_type: 评论,信件
doi:10.1186/cc8847
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:In septic patients, multiple retrospective studies show an association between large volumes of fluids administered in the first 24 h and mortality, suggesting a benefit to fluid restrictive strategies. However, these studies do not directly estimate the causal effects of fluid-restrictive strategies, nor do ...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-020-2767-0
更新日期:2020-02-22 00:00:00
abstract::Mechanically ventilated, intubated patients are at increased risk for tracheal colonization with bacterial pathogens that may progress to heavy bacterial colonization, ventilator-associated tracheobronchitis (VAT), and/or ventilator-associated pneumonia (VAP). Previous studies report that 10 to 30 % of patients with V...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-016-1472-5
更新日期:2016-09-29 00:00:00
abstract:INTRODUCTION:Recent data have suggested that patient admission during intensive care unit (ICU) morning bedside rounds is associated with less favorable outcome. We undertook the present study to explore the association between morning round-time ICU admissions and hospital mortality in a large Canadian health region. ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,多中心研究
doi:10.1186/cc11329
更新日期:2012-05-03 00:00:00
abstract:INTRODUCTION:Resuscitation with saline is a standard initial response to hypotension or shock of almost any cause. Saline resuscitation is thought to generate an increase in cardiac output through a preload-dependent (increased end-diastolic volume) augmentation of stroke volume. We sought to confirm this to be the mec...
journal_title:Critical care (London, England)
pub_type: 临床试验,杂志文章
doi:10.1186/cc2844
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:N-acetylcysteine (NAC) has been shown to improve splanchnic blood flow in experimental studies. This report evaluates the effects of NAC on liver perfusion and lactate signal intensities in the liver tissue of septic shock patients using proton magnetic resonance imaging and spectroscopy. Furthermore, the mo...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc2426
更新日期:2004-04-01 00:00:00
abstract:INTRODUCTION:Dynamic predictors of fluid responsiveness, namely systolic pressure variation, pulse pressure variation, stroke volume variation and pleth variability index have been shown to be useful to identify in advance patients who will respond to a fluid load by a significant increase in stroke volume and cardiac ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,meta分析
doi:10.1186/s13054-014-0584-z
更新日期:2014-10-28 00:00:00
abstract:INTRODUCTION:The present study examined the median survival, life expectancies, and cumulative incidence rate (CIR) of patients undergoing prolonged mechanical ventilation (PMV) stratified by different underlying diseases. METHODS:According to the National Health Insurance Research Database of Taiwan, there were 8,906...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/cc10128
更新日期:2011-01-01 00:00:00
abstract::In the previous issue of Critical Care, Meybohm and colleagues provide evidence to support hypothermia as a kind of therapeutic option for patients suffering cardiac arrest. Although anesthetics had been used to induce hypothermia, sevoflurane post-conditioning fails to confer additional anti-inflammatory effects afte...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc8923
更新日期:2010-01-01 00:00:00
abstract:INTRODUCTION:Blood transfusion in the perioperative period has frequently been associated with an excess of nosocomial infections. Whilst transfused whole blood induces specific host immune alteration that may predispose to nosocomial infections, the immunomodulating properties associated with leukodepleted blood remai...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-014-0541-x
更新日期:2014-10-01 00:00:00
abstract::Heart rate variability in the frequency domain can now be obtained at the bedside in the ICU. Promising data suggest that it may help to characterize a patient response to a spontaneous breathing trial. Refinement of the analysis could even help to predict the outcome of extubation or at least help to detect early pat...
journal_title:Critical care (London, England)
pub_type: 评论,杂志文章
doi:10.1186/cc13807
更新日期:2014-03-31 00:00:00
abstract::Central venous oxygen saturation (ScvO2) >70% or mixed venous oxygen saturation (SvO2) >65% is recommended for both septic and non-septic patients. Although it is the task of experts to suggest clear and simple guidelines, there is a risk of reducing critical care to these simple recommendations. This article reviews ...
journal_title:Critical care (London, England)
pub_type: 杂志文章,评审
doi:10.1186/s13054-014-0579-9
更新日期:2014-11-10 00:00:00
abstract:INTRODUCTION:To determine whether single nucleotide polymorphisms (SNPs) in FAS and related genes are associated with acute kidney injury (AKI) in patients with acute respiratory distress syndrome (ARDS). METHODS:We studied 401 (Caucasian N = 310 and African-American N = 91) patients aged ≥ 13 years with ALI who enrol...
journal_title:Critical care (London, England)
pub_type: 杂志文章
doi:10.1186/s13054-015-1084-5
更新日期:2015-10-19 00:00:00