• J Trauma · Oct 2002

    End-tidal CO2-derived values during emergency trauma surgery correlated with outcome: a prospective study.

    • James G Tyburski, Julianne D Collinge, Robert F Wilson, Arthur M Carlin, Renato G Albaran, and Christopher P Steffes.
    • Department of Surgery, Wayne State University, Detroit, Michigan, USA. jtybursk@med.wayne.edu
    • J Trauma. 2002 Oct 1;53(4):738-43.

    BackgroundThe purpose of this study was to determine whether end-tidal carbon dioxide (PETCO) derived variables assist in evaluating the adequacy of resuscitation during emergency surgery for trauma.MethodsThis was a prospective study of end-tidal derived variables and outcome in 106 trauma patients in an urban Level I trauma center.ResultsThe patients who lived (compared with those who died) had higher final end-tidal Pco levels, lower arterial-end tidal CO differences (Pa-ET)CO, and a decreased alveolar dead space ratio (p < 0.001). The best survival rates were with a PETCO > 27 mm Hg, a (Pa-ET)CO < or = 9 mm Hg, and 96% (56 of 58) for an alveolar dead space ratio < or = 0.20 (p < 0.001). An inappropriately high or "excess Paco also correlated with a decreased (Pa-ET)CO and poorer prognosis. If, after the initial resuscitation, the PETCO -derived values did not achieve these "optimal" levels, survival was significantly reduced.ConclusionDuring emergency trauma surgery, the PETCO and its derived values help to predict outcome and may be used to identify patients needing more aggressive resuscitation.

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