Abstract

Background: End-tidal carbon dioxide (ETCO 2 ) has been shown to correlate with return of spontaneous circulation (ROSC) during cardiac arrest. However, ETCO2 is confounded by a number of factors such as patient physiologic parameters and CPR quality.The relationship of patient Body Mass Index (BMI) to mean intra-arrest ETCO 2 and subsequent ROSC is unknown. Objective: To measure the association of BMI with intra-arrest ETCO 2 and ROSC. Methods: In a single-center cohort of cardiac arrest patients between 7/2007 - 6/2012, we measured ETCO 2 using side-stream capnography during resuscitation efforts, and calculated patient BMI from clinical records. Student’s t-tests were used to compare outcomes. Results: Of the 345 cardiac arrest cases that were recorded, 48 had both BMI and ETCO 2 data available. The mean age of the cohort was 63.1±16.5 yrs, 12/48 (25%) were female and 10/48 (21%) had VF/VT as the initial rhythm, 18/48 (38%) obtained ROSC. When we examined those who obtained ROSC versus those who did not, BMI was significantly less in the cohort that obtained ROSC (23.8±5.9 v 32.0±10.8, p=0.002) and ETCO 2 was higher (34.3±8.9 v 22.4±13.7, p=0.001). There were no statistically significant differences in patient demographics, compression rate or depth between the two groups. Overall, there were no significant interaction between BMI and ETCO 2 (p-value=0.921). Conclusions: BMI was significantly lower and ETCO 2 higher in those patients who had ROSC, though there was not a relationship between BMI and ETCO2, suggesting that ETCO2 can be clinically utilized and interpreted independent of patient habitus.

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