Frequency of Return of Spontaneous Circulation After Effective Cardiopulmonary Resuscitation Monitored by End Tidal Carbon Dioxide

Abstract

Cardiac arrest is a critical emergency with high mortality despite advances in resuscitation. Objectives: To determine the frequency of ROSC after effective CPR and to evaluate the role of ETCO2 monitoring as a predictor of resuscitation outcomes. Methods: This analytical cross-sectional study was conducted in the Department of Emergency Medicine, Central Park Teaching Hospital, Lahore, from May 2024 to September 2024. A total of 127 patients aged 40-70 years who experienced cardiopulmonary arrest were enrolled using non-probability consecutive sampling. CPR was performed with continuous capnography monitoring. Results: The mean age of patients was 56.8 ± 8.5 years; 64.6% were male. The most common cause of arrest was acute myocardial infarction (48.0%), followed by arrhythmias (22.0%), sepsis (16.5%), and respiratory failure (13.5%). ROSC was achieved in 45 patients (35.4%). Patients with ROSC had significantly shorter CPR duration (15.2 ± 5.3minutes vs. 20.6 ± 7 minutes; p<0.001. AnETO2 ≥ 10mmHg after 20 minutes and an abrupt rise in ETCO2 were strongly associated with ROSC (p<0.001). No significant association was found with gender (p=0.610). Myocardial infarction as the cause of arrest was significantly linked with higher ROSC compared to non-cardiac causes (p=0.004). Conclusions: The frequency of ROSC after CPR was 35.4%. ETCO2 monitoring was found to be a reliable predictor of resuscitation success, with higher values and abrupt rises strongly associated with ROSC. Shorter CPR duration and cardiac causes of arrest were favorable prognostic factors.