A comparison of carotid doppler ultrasonography and capnography in evaluating the efficacy of CPR

The end-tidal carbon dioxide (ETCO2) measurement is accepted as the gold standard method for assessing cardiopulmonary resuscitation (CPR) efficacy. In recent studies, the use of Carotid Doppler Ultrasonography has become widespread in showing CPR efficacy. In the present study, the carotid blood fl...

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Veröffentlicht in:The American journal of emergency medicine 2018-09, Vol.36 (9), p.1545-1549
Hauptverfasser: Yilmaz, Gökhan, Silcan, Mustafa, Serin, Süha, Caglar, Bahadır, Erarslan, Özkan, Parlak, İsmet
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container_issue 9
container_start_page 1545
container_title The American journal of emergency medicine
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creator Yilmaz, Gökhan
Silcan, Mustafa
Serin, Süha
Caglar, Bahadır
Erarslan, Özkan
Parlak, İsmet
description The end-tidal carbon dioxide (ETCO2) measurement is accepted as the gold standard method for assessing cardiopulmonary resuscitation (CPR) efficacy. In recent studies, the use of Carotid Doppler Ultrasonography has become widespread in showing CPR efficacy. In the present study, the carotid blood flow measurement was compared with ETCO2 measurement and an evaluation was made of whether this method could be used as an alternative method to capnography in the assessment of CPR efficacy. This study was conducted on patients who presented at the Emergency Department (ED) with non-traumatic arrest or began to suffer from arrest during emergency service follow-up. The main carotid artery peak systolic velocity (PSV), end diastolic velocity (EDV) and time-dependent mean flow velocity (MNV), and ETCO2 values were measured and recorded after the 100th chest pressure of the CPR cycle and the results were statistically analyzed. The mean age of the patients was 54.5±12.3years and 65.6% of the patients were male. The mean values of patients measured from the carotid artery during the CPR were PSV 67.1±17.3, EDV 16.3±4.5, MNV 25.5±8.1 and ETCO2 22.2±8.1. A significant difference was found between in-hospital and out-of-hospital arrests in terms of patient outcome (return of spontaneous circulation (ROSC) and death) (p
doi_str_mv 10.1016/j.ajem.2018.01.022
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In recent studies, the use of Carotid Doppler Ultrasonography has become widespread in showing CPR efficacy. In the present study, the carotid blood flow measurement was compared with ETCO2 measurement and an evaluation was made of whether this method could be used as an alternative method to capnography in the assessment of CPR efficacy. This study was conducted on patients who presented at the Emergency Department (ED) with non-traumatic arrest or began to suffer from arrest during emergency service follow-up. The main carotid artery peak systolic velocity (PSV), end diastolic velocity (EDV) and time-dependent mean flow velocity (MNV), and ETCO2 values were measured and recorded after the 100th chest pressure of the CPR cycle and the results were statistically analyzed. The mean age of the patients was 54.5±12.3years and 65.6% of the patients were male. The mean values of patients measured from the carotid artery during the CPR were PSV 67.1±17.3, EDV 16.3±4.5, MNV 25.5±8.1 and ETCO2 22.2±8.1. A significant difference was found between in-hospital and out-of-hospital arrests in terms of patient outcome (return of spontaneous circulation (ROSC) and death) (p&lt;0.05). The mean ETCO2 values of those who died were found to be lower than those of the ROSC group (p&lt;0.05). Although there was a positive and low-level of correlation between the ETCO2 values and PSV values, and a positive and very low-level of correlation between the EDV and MNV values of all patients, these correlations were not statistically significant. (p&gt;0.05). A low correlation was found between the PSV and ETCO2 values. With effective CPR, the results close to carotid blood flow in normal healthy individuals were obtained. 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In recent studies, the use of Carotid Doppler Ultrasonography has become widespread in showing CPR efficacy. In the present study, the carotid blood flow measurement was compared with ETCO2 measurement and an evaluation was made of whether this method could be used as an alternative method to capnography in the assessment of CPR efficacy. This study was conducted on patients who presented at the Emergency Department (ED) with non-traumatic arrest or began to suffer from arrest during emergency service follow-up. The main carotid artery peak systolic velocity (PSV), end diastolic velocity (EDV) and time-dependent mean flow velocity (MNV), and ETCO2 values were measured and recorded after the 100th chest pressure of the CPR cycle and the results were statistically analyzed. The mean age of the patients was 54.5±12.3years and 65.6% of the patients were male. 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In recent studies, the use of Carotid Doppler Ultrasonography has become widespread in showing CPR efficacy. In the present study, the carotid blood flow measurement was compared with ETCO2 measurement and an evaluation was made of whether this method could be used as an alternative method to capnography in the assessment of CPR efficacy. This study was conducted on patients who presented at the Emergency Department (ED) with non-traumatic arrest or began to suffer from arrest during emergency service follow-up. The main carotid artery peak systolic velocity (PSV), end diastolic velocity (EDV) and time-dependent mean flow velocity (MNV), and ETCO2 values were measured and recorded after the 100th chest pressure of the CPR cycle and the results were statistically analyzed. The mean age of the patients was 54.5±12.3years and 65.6% of the patients were male. 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However, the study showed that carotid blood flow measurement results during CPR were not as valuable as ETCO2 in demonstrating CPR efficacy.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>29321118</pmid><doi>10.1016/j.ajem.2018.01.022</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-7621-553X</orcidid></addata></record>
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subjects Adolescent
Adult
Aged
Blood flow
Blood Flow Velocity - physiology
Capnography
Carbon dioxide
Cardiac arrhythmia
Cardiopulmonary resuscitation
Cardiopulmonary Resuscitation - methods
Carotid Arteries - diagnostic imaging
Carotid Arteries - physiology
Carotid artery
Carotid blood flow
Comorbidity
CPR
Diabetes
Doppler effect
Emergency medical care
Emergency medical services
End-tidal CO2. carotid doppler ultrasonography
Female
Flow velocity
Heart Arrest - therapy
Hospitals
Humans
Hypertension
Intubation
Length of Stay - statistics & numerical data
Male
Middle Aged
Out-of-Hospital Cardiac Arrest - therapy
Patients
Prospective Studies
Statistical analysis
Ultrasonic imaging
Ultrasonography, Doppler
Ultrasound
Young Adult
title A comparison of carotid doppler ultrasonography and capnography in evaluating the efficacy of CPR
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