Evaluating the utility of end-tidal CO₂ as a predictor of mortality in trauma victims: A systematic review and meta-analysis.

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2024-12-09 DOI:10.1016/j.amjsurg.2024.116130

Salma Al-Aomar, Jehad Feras AlSamhori, Hamza Alzghoul, Hatem Al-Ghraibeh, Ghayda'a Al-Majali, Samantha Tarras, Heather Dolman, James Tyburski, Gamal Mostafa, Awni D Shahait

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引用次数: 0

Abstract

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.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.