Acute cardiac care & resuscitation
The peak end-tidal carbon dioxide concentration recorded during cardiopulmonary resuscitation as an indicator of survival: a nationwide cohort study of pediatric out-of-hospital cardiac arrests
Authors' conclusion
Further studies are necessary to clarify the use of ETCO2 in optimizing pediatric ALS.
Study context
- Population
- Patients under 18 years of age with trauma-related or medical out-of-hospital cardiac arrest (OHCA)trauma-related 226 (19%) · medical 983 (81%)
- Participants
- 1,209 pediatric OHCAs
- Exposure
- Highest ETCO2 recorded during advanced cardiopulmonary resuscitation as a predictor of return of spontaneous circulation (ROSC) and d30 survival (AUROC; Youden index for optimal cut-off)
- Trauma-related OHCAn = 226
- Medical OHCAn = 983
- Outcome
- Return of spontaneous circulation (ROSC) and day (d)30 survival; discriminant ability of highest ETCO2
- Follow-up
- D30
Methodological detailsFrench RéAC OHCA registry, 2011 to 2023
- French RéAC OHCA registry
- 2011 to 2023
Main finding
As reported in the abstract
| Group | AUROC [95% CI] for ROSC | AUROC [95% CI] for d30 survival | Optimal cut-off for ROSC | Optimal cut-off for d30 survival |
|---|---|---|---|---|
| Trauma-related OHCA | 0.808 [0.745-0.872] | 0.854 [0.761-0.947] | 21 mmHg | 29 mmHg |
| Medical OHCA | 0.803 [0.774-0.831] | 0.732 [0.676-0.787] | 27 mmHg | 26 mmHg |
AUROC [95% CI] for ROSC
Trauma-related OHCA0.808 [0.745-0.872]
Medical OHCA0.803 [0.774-0.831]
AUROC [95% CI] for d30 survival
Trauma-related OHCA0.854 [0.761-0.947]
Medical OHCA0.732 [0.676-0.787]
Optimal cut-off for ROSC
Trauma-related OHCA21 mmHg
Medical OHCA27 mmHg
Optimal cut-off for d30 survival
Trauma-related OHCA29 mmHg
Medical OHCA26 mmHg
- ROSC achieved
- 347 (29%)
- d30 survival achieved
- 61 (5%)
Observational data: associations, not effects.
Further findings
- Median [interquartile range] age
- 6 [0;14] years
Original publication
The peak end-tidal carbon dioxide concentration recorded during cardiopulmonary resuscitation as an indicator of survival: a nationwide cohort study of pediatric out-of-hospital cardiac arrests. Resuscitation. Published 29 April 2025. doi:10.
Summarised from the published abstract; every number is checked against it