During CPR, which end-tidal CO2 (ETCO2) value has been associated with poor prognosis and may be used to guide termination of resuscitation after 20 minutes of ACLS?

• A ETCO2 < 35 mmHg
• B ETCO2 < 25 mmHg
• C ETCO2 < 15 mmHg at any point
• D ETCO2 < 10 mmHg after 20 minutes of CPR ✓

Explanation

ETCO2 during CPR reflects cardiac output generated by chest compressions; values reflect both CPR quality and viability of myocardium. An ETCO2 <10 mmHg after 20 minutes of adequate ACLS has been associated with failure to achieve ROSC and very poor survival outcomes. AHA guidelines suggest ETCO2 <10 mmHg after 20 minutes can be considered as one factor (not sole criterion) for terminating resuscitation in intubated patients. A sudden rise in ETCO2 during CPR is an early indicator of ROSC.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.