The return of spontaneous circulation in patients with out-of-hospital cardiopulmonary arrest and the investigation of blood gas parameters and end-tidal carbon dioxide value as short-term neurological recovery

The Return of Spontaneous Circulation in Patients With out-of-Hospital Cardiopulmonary Arrest and the Investigation of Blood Gas Parameters and End-Tidal Carbon Dioxide Value as Short-Term Neurological Recovery İntroduction: Mortality rates after sudden cardiopulmonary arrest are high. The interventions in this period are aimed to return of spontaneous circulation of the patient (ROSC) and reducing the post-turn neurological damage. The blood gas analysis and endtidal carbon dioxide measurement are the easiest to use and evaluate from the parameters of the patient's response to treatment during resuscitation. We aimed to evaluate the usefulness of these parameters in predicting ROSC and in evaluating post-ROSC neurological survival in our study. Method: The study was conducted prospectively at Atatürk University Research Hospital Emergency Department for 1 year. Blood gas samples were taken with a heparinized syringe at the arrival of patients who came from outside the hospital as cardiopulmonary arrest (OHCA) and, if provided, after ROSC. Endotidal carbon dioxide (EtCO2) values were measured and recorded when patients were intubated with endotracheal tube at the same time with capnography and when ROSC was given. The neurological assessment of ROSC-treated patients was made by calculating the cerebral performance capacity (CPC) score at the 1st hour and at discharge. The results of the analysis of patients with Ex and ROSC were evaluated statistically. Findings: A total of 155 patients were included in the study to form the control group of patients with ROSC. The mean age of the patients was 65,45 ± 15,12 (17-93) for the whole group and 58,7% were male. It was shown that PO2, PCO2 and the EtCO2 value measured by capnography were heve a prognostic marker for the supply of ROSC (p< 0,05). The lactate and BE values measured by the blood gas was also found to be insignificant in the prediction of ROSC (p> 0.05). Conversely, AaDCO2 was found to be significant in ROSC estimation (p <0.05) but not in neurological evaluation (p> 0.05). Conclusion: As a result of our work, blood gas parameters and EtCO2 alone are sufficient in predicting ROSC. The value of AaDCO2 calculated using EtCO2 and PO2 may be used in predicting the prognosis of OHCA patients. But it does not give any idea about neurological survival. Key words: Out of hospital cordiopulmonary arrest, blood gas, lactat, endtidal carbondioxide, arteriolaralveolar carbondioxide difference.