Stroke volumes and end-tidal carbon dioxide generated by precordial compression during ventricular fibrillation

Crit Care Med. 2003 Jun;31(6):1819-23. doi: 10.1097/01.CCM.0000069538.12447.82.


Objective: The objective of this study was to measure stroke volumes produced by precordial compression during cardiopulmonary resuscitation and to quantitate relationships of stroke volume to measurements of end-tidal carbon dioxide.

Design: A prospective, observational animal study.

Setting: Medical research laboratory in a university-affiliated research and educational foundation.

Subjects: Domestic pigs.

Interventions: Eighteen anesthetized male, domestic pigs weighing between 40 and 45 kg were investigated. Ventricular fibrillation was electrically induced and continued for intervals ranging from 4 to 10 mins. Precordial compression was maintained at 80 per minute together with mechanical ventilation after endotracheal intubation.

Measurements and main results: Stroke volumes were measured with the aid of transesophageal echocardiographic imaging. End-tidal carbon dioxide was quantitated with conventional capnography. Baseline values of thermodilution cardiac output were highly correlated with echocardiographic measurements (r =.92). The stroke volume index produced by precordial compression averaged 0.45 mL/kg or approximately 37% of the average prearrest value of 1.22 mL/kg. The end-tidal carbon dioxide was highly predictive of stroke volume index (r =.88, p <.001) with a mean bias of 0.003 mL/kg.

Conclusions: We confirmed that precordial compression produces approximately one third of prearrest stroke volumes during cardiopulmonary resuscitation and demonstrated that end-tidal carbon dioxide was quantitatively predictive of stroke volume index estimated by transesophageal echocardiographic imaging.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Animals
  • Carbon Dioxide / metabolism*
  • Cardiopulmonary Resuscitation*
  • Echocardiography, Transesophageal
  • Observer Variation
  • Predictive Value of Tests
  • Prospective Studies
  • Regression Analysis
  • Stroke Volume / physiology*
  • Swine
  • Ventricular Fibrillation / diagnosis
  • Ventricular Fibrillation / therapy*


  • Carbon Dioxide