Which physiologic data is used in deciding to terminate resuscitation?

Which physiologic data is used in deciding to terminate resuscitation?

• A. ETCO2 less than 10 mmHg after 20 minutes of high-quality CPR
• B. How much time elapsed before CPR was initiated
• C. Indication that ROSC has occurred
• D. The presence of a pulse

Answer: (A)

End-tidal CO2 reflects how well chest compressions are perfusing the body and thus serves as a real-time physiologic indicator of CPR effectiveness. If, after around 20 minutes of high-quality CPR, the end-tidal CO2 remains very low—typically below 10 mmHg—the likelihood of returning spontaneous circulation is extremely low. In that scenario, and assuming no reversible causes are present, termination of resuscitation can be considered. Time elapsed before CPR started is important for prognosis but is not a current physiologic measure of ongoing CPR performance. The appearance of ROSC or a detectable pulse during resuscitation indicates improvement or return of circulation, which argues against terminating.

End-tidal CO2 reflects how well chest compressions are perfusing the body and thus serves as a real-time physiologic indicator of CPR effectiveness. If, after around 20 minutes of high-quality CPR, the end-tidal CO2 remains very low—typically below 10 mmHg—the likelihood of returning spontaneous circulation is extremely low. In that scenario, and assuming no reversible causes are present, termination of resuscitation can be considered.

Time elapsed before CPR started is important for prognosis but is not a current physiologic measure of ongoing CPR performance. The appearance of ROSC or a detectable pulse during resuscitation indicates improvement or return of circulation, which argues against terminating.