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| ID | Type | Description | Link |
|---|---|---|---|
| ERP#14222 | Other Grant/Funding Number | Medtronic |
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| Name | Class |
|---|---|
| Medtronic | INDUSTRY |
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The investigators aim to assess the relationship between patient characteristics, prehospital treatments, and vital signs to determine if a threshold EtCO2 value, a change in EtCO2 value (final - initial), or a trend in EtCO2 (positive/negative) is a better predictor of patient survival to discharge. The secondary aim of this project is to identify significant predictors of neurologically intact patient survival as indicated by a cerebral performance category (CPC) score of 1-2.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| stable ETCO2 | low variation in measured end-tidal CO2 during cpr; low/high threshold yet to be determined | ||
| unstable/trending ETCO2 | variability in end-tidal CO2 during CPR, with or without measurable trend |
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| Measure | Description | Time Frame |
|---|---|---|
| Survival to Hospital Discharge | lack of terminiation of CPR during prehospital or in hospital care | 90 days |
| Measure | Description | Time Frame |
|---|---|---|
| Neurologically Intact Patient Survival | Based on Gasgow-Pittsburgh Cerebral Performance Category (CPC) score which ranges from 1 (best) to 5 (worst). Neurologically intact is defined as a score of 1-2 among survivors | 90 days |
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Inclusion Criteria
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This is a retrospective cohort study. All patients encountered by emergency medical services in Oklahoma City and Tulsa experiencing an out-of-hospital cardiac arrest from Jan 1, 2024, to July 1, 2025, will be evaluated against the inclusion and exclusion criteria.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Office of the Medical Director of EMS for Metropolitan Oklahoma City and Tulsa | Oklahoma City | Oklahoma | 73135 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 34879495 | Background | Sun KF, Poon KM, Lui CT, Tsui KL. Clinical prediction rule of termination of resuscitation for out-of-hospital cardiac arrest patient with pre-hospital defibrillation given. Am J Emerg Med. 2021 Dec;50:733-738. doi: 10.1016/j.ajem.2021.09.058. Epub 2021 Sep 29. | |
| 37751228 | Background | Smida T, Menegazzi JJ, Crowe RP, Salcido DD, Bardes J, Myers B. The Association of Prehospital End-Tidal Carbon Dioxide with Survival Following Out-of-Hospital Cardiac Arrest. Prehosp Emerg Care. 2024;28(3):478-484. doi: 10.1080/10903127.2023.2262566. Epub 2023 Oct 6. |
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| ID | Term |
|---|---|
| D058687 | Out-of-Hospital Cardiac Arrest |
| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| 27227208 | Background | Richardson M, Moulton K, Rabb D, Kindopp S, Pishe T, Yan C, Akpinar I, Tsoi B, Chuck A. Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Mar. Available from http://www.ncbi.nlm.nih.gov/books/NBK362374/ |
| 37809508 | Background | Kudu E, Danis F, Karaca MA, Erbil B. Usability of EtCO2 values in the decision to terminate resuscitation by integrating them into the TOR rule (an extended TOR rule): A preliminary analysis. Heliyon. 2023 Sep 13;9(9):e19982. doi: 10.1016/j.heliyon.2023.e19982. eCollection 2023 Sep. |
| 15368978 | Background | Hatlestad D. Capnography as a predictor of the return of spontaneous circulation. Emerg Med Serv. 2004 Aug;33(8):75-80; quiz 115. |
| 38104387 | Background | Hambelton C, Wu L, Smith J, Thompson K, Neth MR, Daya MR, Jui J, Lupton JR. Utility of end-tidal carbon dioxide to guide resuscitation termination in prolonged out-of-hospital cardiac arrest. Am J Emerg Med. 2024 Mar;77:77-80. doi: 10.1016/j.ajem.2023.11.030. Epub 2023 Dec 7. |
| 22107764 | Background | Eckstein M, Hatch L, Malleck J, McClung C, Henderson SO. End-tidal CO2 as a predictor of survival in out-of-hospital cardiac arrest. Prehosp Disaster Med. 2011 Jun;26(3):148-50. doi: 10.1017/S1049023X11006376. |
| 28704248 | Background | Dudaryk R, Bodzin DK, Ray JJ, Jabaley CS, McNeer RR, Epstein RH. Low End-Tidal Carbon Dioxide at the Onset of Emergent Trauma Surgery Is Associated With Nonsurvival: A Case Series. Anesth Analg. 2017 Oct;125(4):1261-1266. doi: 10.1213/ANE.0000000000002283. |