Abstract
Capnography has shown to be an invaluable tool in assessing trauma victims in different setups. To elucidate this, we conducted this meta-analysis to evaluate the utility of end-tidal CO2 (ETCO2) and the arterial CO2 -ETCO2 gap (PaCO2-ETCO2) measurements on predictiveness for mortality in trauma patients. A systematic literature search was performed (01/1990-06/2023). The inclusion criteria included adult trauma patients, with mention of mortality. The primary outcome was evaluating the reliability of ETCO2 in predicting mortality. Seventeen studies were included, with total of 3445 patients. Mean age was 39.08-year, 22.3% female. Overall mortality was 25.6%, mostly retrospective studies. Mean ETCO2 in survivors was 31.45mmHg, and 24.75mmHg in deceased patients, (p=0.0128). Mean PaCO2-ETCO2 gap in survivors was 6.8mmHg, and 15.0mmHg in deceased patients, (p<0.001). Using receiver operator characteristic curve analysis, ETCO2 of 30.2mmHg with high sensitivity to predict mortality. Low ETCO2 or a wide PaCO2-ETCO2 gap were significantly correlated with poor outcomes in trauma patients. This easily obtained value can help predict those who need more aggressive treatments.
Published Version
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