A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry: a multicenter observational study  

作　　者：Jing Yang Hanqi Tang Shihuan Shao Feng Xu Yangyang Fu Shengyong Xu Chen Li Yan Li Yang Liu Joseph Harold Walline Huadong Zhu Yuguo Chen Xuezhong Yu Jun Xu 

机构地区：[1]Emergency Department,State Key Laboratory of Complex Severe and Rare Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Science and Peking Union Medical College,Beijing 100730,China [2]Emergency Department,Peking University People’s Hospital,Beijing 100044,China [3]Department of Emergency and Chest Pain Center,Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine,Key Laboratory of Emergency and Critical Care Medicine of Shandong Province,Qilu Hospital of Shandong University,Jinan 250012,China [4]Emergency Department,Beijing Jishuitan Hospital,Beijing 100035,China [5]Emergency Department,Tianjin Medical University General Hospital,Tianjin 300052,China [6]Department of Emergency Medicine,Penn State Health Milton S.Hershey Medical Center and Penn State College of Medicine,Hershey 17033,USA

出　　处：《World Journal of Emergency Medicine》2024年第1期16-22,共7页世界急诊医学杂志（英文）

基　　金：supported by National Natural Science Foundation of China General Program (82172179);Mathematics Tianyuan Fund (12126604);Central High-level Hospital Clinical Research Project (2022-PUMCH-B-110)

摘　　要：BACKGROUND:Unsustained return of spontaneous circulation(ROSC)is a critical barrier to survival in cardiac arrest patients.This study examined whether end-tidal carbon dioxide(ETCO_(2))and pulse oximetry photoplethysmogram(POP)parameters can be used to identify unsustained ROSC.METHODS:We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.Patients’general information,ETCO_(2),and POP parameters were collected and statistically analyzed.RESULTS:The included 105 ROSC episodes(from 80 cardiac arrest patients)comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes.The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group(29.2%vs.9.4%,P<0.05).The logistic regression analysis showed that the difference between after and before ROSC in ETCO_(2)(ΔETCO_(2))and the difference between after and before ROCS in area under the curve of POP(ΔAUCp)were independently associated with sustained ROSC(odds ratio[OR]=0.931,95%confi dence interval[95%CI]0.881-0.984,P=0.011 and OR=0.998,95%CI 0.997-0.999,P<0.001).The area under the receiver operating characteristic curve ofΔETCO_(2),ΔAUCp,and the combination of both to predict unsustained ROSC were 0.752(95%CI 0.660-0.844),0.883(95%CI 0.818-0.948),and 0.902(95%CI 0.842-0.962),respectively.CONCLUSION:Patients with unsustained ROSC have a poor prognosis.The combination ofΔETCO_(2) andΔAUCp showed signifi cant predictive value for unsustained ROSC.

关 键 词：Return of spontaneous circulation Pulse oximetry photoplethysmogram End-tidal carbon dioxide Cardiac arrest Cardiopulmonary resuscitation 

分 类 号：R541.78[医药卫生—心血管疾病]