American journal of surgery · 2024
Evaluating the utility of end-tidal CO2 as a predictor of mortality in trauma victims: A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Al-Aomar Salma, AlSamhori Jehad Feras, Alzghoul Hamza, Al-Ghraibeh Hatem, Al-Majali Ghayda'a, Tarras Samantha, Dolman Heather, Tyburski James, Mostafa Gamal, Shahait Awni D
Аннотация
BACKGROUND: Capnography has shown to be an invaluable tool in assessing trauma victims in different setups. To elucidate this, we conducted this meta-analysis to evaluate the utility of end-tidal CO2 (ETCO2) and the arterial CO2 -ETCO2 gap (PaCO2-ETCO2) measurements on predictiveness for mortality in trauma patients.
METHODS: A systematic literature search was performed (01/1990-06/2023). The inclusion criteria included adult trauma patients, with mention of mortality. The primary outcome was evaluating the reliability of ETCO2 in predicting mortality.
RESULTS: Seventeen studies were included, with total of 3445 patients. Mean age was 39.08-year, 22.3 % female. Overall mortality was 25.6 %, mostly retrospective studies. Mean ETCO2 in survivors was 31.45 mmHg, and 24.75 mmHg in deceased patients, (p = 0.0128). Mean PaCO2-ETCO2 gap in survivors was 6.8 mmHg, and 15.0 mmHg in deceased patients, (p < 0.001). Using receiver operator characteristic curve analysis, ETCO2 of 30.2 mmHg with high sensitivity to predict mortality.
CONCLUSION: Low ETCO2 or a wide PaCO2-ETCO2 gap were significantly correlated with poor outcomes in trauma patients. This easily obtained value can help predict those who need more aggressive treatments.
METHODS: A systematic literature search was performed (01/1990-06/2023). The inclusion criteria included adult trauma patients, with mention of mortality. The primary outcome was evaluating the reliability of ETCO2 in predicting mortality.
RESULTS: Seventeen studies were included, with total of 3445 patients. Mean age was 39.08-year, 22.3 % female. Overall mortality was 25.6 %, mostly retrospective studies. Mean ETCO2 in survivors was 31.45 mmHg, and 24.75 mmHg in deceased patients, (p = 0.0128). Mean PaCO2-ETCO2 gap in survivors was 6.8 mmHg, and 15.0 mmHg in deceased patients, (p < 0.001). Using receiver operator characteristic curve analysis, ETCO2 of 30.2 mmHg with high sensitivity to predict mortality.
CONCLUSION: Low ETCO2 or a wide PaCO2-ETCO2 gap were significantly correlated with poor outcomes in trauma patients. This easily obtained value can help predict those who need more aggressive treatments.