Can an initial end-tidal CO2 <1.33 kPa predict lack of return of spontaneous circulation during pre-hospital cardiac arrest?

Results We registered data from 595 cardiac arrest patients; in 58.9 % (n=350) of these cases the pre-hospital critical care teams performed pre-hospital endotracheal intubation. An initial end-tidal CO2 measurement following prehospital endotracheal intubation were available in 270 cases. We identified 22 patients, who had an initial ETCO2 below 1.33 kPa. Four of these patients achieved return of spontaneous circulation. All four patients were admitted to hospital, three with stable circulation and one with ongoing automated CPR due to recurrent cardiac arrest. Conclusion Our results indicates that an initial ETCO2 below 1.33 kPa during pre-hospital cardiac arrest should not be used as a cut-off value for the achievability of return of spontaneous circulation.