End-tidal carbon dioxide monitoring may be associated with a higher possibility of return of spontaneous circulation during out-of-hospital cardiac arrest: a population-based study

摘要

Background During cardiac arrest, end-tidal carbon dioxide (ETCO₂) monitoring is recommended as a chest compression performance indicator. However, its frequency of use during out-of-hospital cardiac arrest (OHCA) and its benefits have never been evaluated in real clinical situations. Objective We investigated OHCA patients in Taiwan to evaluate the frequency of ETCO₂ monitoring and its effects on sustained return of spontaneous circulation (ROSC). Methods We sampled the Taiwan National Health Insurance claims database, which contains 1 million beneficiaries. All adult beneficiaries older than 18?years who presented with OHCA and received chest compression between 1 January 2005 and 31 December 2012 were enrolled. We further identified patients with ETCO₂ monitoring and matched each 1 with 20 patients who did not receive ETCO₂ monitoring based on their propensity scores. A simple conditional logistic regression model was applied to compare the odds ratio (OR) for sustained ROSC in the matched cohorts. Results A total of 5041 OHCA patients were enrolled. The frequency of ETCO₂ monitoring has increased since 2010 but still is low. After matching, 53 patients with ETCO₂ monitoring and 1060 without ETCO₂ monitoring were selected. The OR of sustained ROSC in the ETCO₂ group was significantly increased (2.38, 95?% CI 1.28–4.42). Conclusion Patients who received ETCO₂ monitoring during OHCA had a higher possibility of sustained ROSC, but the overall use of ETCO₂ monitoring is still low despite strong recommendations for its use.