El dióxido de carbono al final de la espiración como signo precoz y valor pronóstico de la recuperación de la circulación espontánea en la parada cardiaca extrahospitalaria: una revisión sistemática

Background: There is no clear evidence on the \nmaximum level of end-tidal carbon dioxide (ETCO2) predictor \nof the return of spontaneous circulation (RSC) after \nan out-of-hospital cardiorespiratory arrest. The aims \nof this work was to synthesise and analyse the available \nevidence on the usefulness of monitoring values ETCO2 \nin an out-of-hospital cardiorespiratory arrest as an early \nsign and prognostic indicator of the RSC. \nMethods: Systematic review, with narrative synthesis \nof the results, of primary studies published in English \nor Spanish was conducted in Medline, CINAHL, Web \nof Science, EMBASE, Proquest, Scopus, Cochrane, \nÍnDICEs CSIC and CUIDEN of studies that analyse the \nusefulness of monitoring of the level of ETCO2 as a sign \nof the RSC after an out-of-hospital cardiorespiratory \narrest. PRISMA declaration was followed. The risk of \nbias was assessed with the Newcastle-Ottawa Scale. \nResults: 1,011 studies were found, eight of which fulfilled \nthe inclusion criteria. The studies reported an association \nbetween the abrupt increase in ETCO2 and RSC to \ndisagree on the predictive cut-off points (an increase than \n10 mmHg and initial values or three minutes greater than \n10 mmHg or 19 mmHg). The studies were of moderate to \nhigh methodological quality. \nConclusions: ETCO2 values correlate with the RSC \nin adults with cardiorespiratory arrest and could predict \nnon-survival, so they should be incorporated into advanced \nlife support algorithms and Utstein-style reports.