Association between capnographic changes during pulse checks of varying durations and clinical outcomes during cardiopulmonary resuscitation: a multicenter study from Türkiye (CaPTuRe)
Resuscitation, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.resuscitation.2026.111358
- Dergi Adı: Resuscitation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, Academic Search Ultimate (EBSCO)
- Anahtar Kelimeler: Capnography, Cardiopulmonary resuscitation, Emergency department, Pulse check duration
- Recep Tayyip Erdoğan Üniversitesi Adresli: Evet
Özet
Aim: To investigate the association between capnographic changes during pulse checks of different durations and cardiopulmonary resuscitation (CPR) outcomes. Methods: This multicenter, prospective, controlled, quasi-randomized study categorized patients according to pulse check duration: Group A (≤5 s) and Group B (>5–≤10 s). Five measurements were obtained during the first six CPR cycles. Four capnographic parameters were evaluated for each measurement: Post-CPR end-tidal carbon dioxide (ETCO2), Pre-CPR ETCO2, loss rate (percentage decrease between Post- and Pre-CPR ETCO2), and recovery time (time required to regain the previous cycle's Post-CPR ETCO2). Results: The study included 252 cardiac arrest patients (Group A, n = 124; Group B, n = 128). In Group A, patients with return of spontaneous circulation (ROSC) had markedly lower loss rates and shorter recovery times than non-survivors, together with higher pre- and post-CPR ETCO2 values (all p < 0.001). Group A also had a higher ROSC rate than Group B (36.3% vs. 19.5%; p = 0.005). Logistic regression identified pulse check duration as an independent predictor of ROSC, with Group A having 2.39-fold higher odds of ROSC than Group B (odds ratio [OR] = 2.39, 95% confidence interval [CI] = 1.347–4.242; p = 0.003). Pre-CPR ETCO2 was strongly negatively correlated with loss rate (ρ = −0.770), whereas Pre- and Post-CPR ETCO2 values (ρ = 0.96) and loss rate and recovery time (ρ = 0.89) were strongly positively correlated. Conclusion: Pulse checks completed within 5 s were associated with more favorable capnographic dynamics and higher ROSC rates than those lasting 6–10 s. These findings are hypothesis-generating and warrant prospective validation.