Key result
End-tidal CO2 may be a better indicator of haemodynamic events compared to mean arterial blood pressure during resuscitation in haemorrhagic shock, as it reflects changes in cardiac output earlier.
Why the study?
Does end-tidal CO2 correlate better with hemodynamic events than mean arterial blood pressure during resuscitation in haemorrhagic shock?
Does end-tidal CO2 correlate better with hemodynamic events than mean arterial blood pressure during resuscitation in haemorrhagic shock?
End-tidal CO2 may serve as a more reliable indicator of cardiac output and hemodynamic status than mean arterial blood pressure during resuscitation from hemorrhagic shock.
Answers are grounded in this paper and cite their sources.
EtCO2 monitoring merits human validation in hemorrhagic shock; animal data leave clinical adoption premature.
The relationship between end-tidal CO2 (ETCO2), mean arterial blood pressure (MAP) and neuroendocrine response was investigated in experimentally induced haemorrhagic shock in six anaesthetized, spontaneously breathing dogs. One third of the calculated whole blood volume, i.e. 30 ml/kg was gradually withdrawn in 32 minutes. After 16 minutes, the blood was transfused to the dogs. Blood samples were taken regularly for plasma adrenaline noradrenaline, beta-endorphin and serum cortisol levels. MAP and ETCO2 decreased simultaneously during the withdrawal period. MAP increased before resuscitation commenced due to the increased sympathetic response, confirmed by high adrenalin levels. ETCO2 remained low, suggesting that ETCO2 reflects changes in cardiac output earlier during resuscitation when compared to MAP. Adrenaline, noradrenaline, beta-endorphin and cortisol levels increased during haemorrhagic shock and slowly decreased during resuscitation. The results of the study proved a good correlation and clinical relevance of ETCO2 and MAP during development of haemorrhagic shock while the difference between ETCO2 and MAP increased during resuscitation, suggesting the influence of sympathetic response, confirmed by increased levels of adrenaline. According to a proven positive correlation between ETCO2 and cardiac output during haemorrhagic shock, the results suggest that ETCO2 may be used as a better indicator of haemodynamic events when compared to MAP during a resuscitation period in haemorrhagic shock.
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Alenka et al. (2006) studied Experimentally induced haemorrhagic shock (n=6). Gradual withdrawal of one third of calculated whole blood volume followed by transfusion was evaluated on Relationship between end-tidal CO2 (ETCO2), mean arterial blood pressure (MAP) and neuroendocrine response. End-tidal CO2 may be a better indicator of haemodynamic events compared to mean arterial blood pressure during resuscitation in haemorrhagic shock, as it reflects changes in cardiac output earlier.
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