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Application of End-tidal Carbon Dioxide Concentration during Cardiopulmonary Resuscitation: A Review of the Literature

潮氣末二氧化碳濃度於心肺復甦的應用

摘要


2005年美國心臟醫學會於新版高級救命術(ACLS)中強調:高品質心肺復甦術必需包含高效率的胸部按壓以及合理的換氣量,維持較高的冠狀動脈灌注壓和充足的血氧含量。非侵襲性潮氣末二氧化碳分壓(partial pressure of end-tidal CO2, PetCO2)可立即評估心輸出量及間接瞭解冠狀動脈灌注量和病人的呼吸系統及代謝功能,所以被列為必要之監測工具。1999年國際緊急醫療醫師協會亦建議:將PetCO2監測列為到院前及急診中緊急照護必備的標準程序。我們將回顧PetCO2的測量,潮氣末二氧化碳分壓監測至臨床運用的演進。寄望藉此提醒我們:PetCO2於進行院外或急診室心肺復甦時,用來監測體外心臟按壓的有效性及確認氣管內插管的位置,有其應當受到重視的特色。

並列摘要


In 2005, the American Heart Association guidelines for advanced cardiac life support emphasized that cardiopulmonary resuscitation (CPR) should include effective chest compression and reasonable ventilation to provide the patient a higher coronary artery perfusion pressure and adequate oxygenation. Therefore, these two indicators became the main factors determining whether CPR was successful. The measurement of the partial pressure of end-tidal CO2, (PetCO2) is a non-invasive primary method; it is used to monitor the patient's cardiac output, coronary perfusion pressure, ventilation and systemic metabolic function during resuscitation. In 1999, the National Association of Emergency Medical Service Physicians recommended that PetCO2 monitoring be standard in pre-hospital care and in emergency departments. We will review the literature on the measurement of PetCO2, and the evolution of monitoring as well as the use of PetCO2 for monitoring efficacy in CPR. This information is used to substantiate the clinical utilization and predict the probability of success of endotracheal tube placement in the emergency department.

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