Prehospital end-tidal carbon dioxide concentration and outcome in major trauma

J Trauma. 2004 Jul;57(1):65-8. doi: 10.1097/01.ta.0000103984.70306.22.


Background: End-tidal carbon dioxide (Petco2) concentration is a marker of the pathophysiologic state because it is a reflection of cardiac output. Petco2 correlates with outcome after prehospital primary cardiac arrest, but association with outcome from prehospital trauma has not been established.

Methods: Between 1998 and 2001, Petco2 was recorded in 191 blunt trauma patients requiring prehospital intubation. Rapid sequence intubation was performed using suxamethonium (1 mg/kg) and etomidate (0.2-0.3 mg/kg). Initial Petco2 after endotracheal intubation (t0) and Petco2 at 20 minutes after endotracheal intubation (t20) were recorded, together with survival to discharge.

Results: Median Petco2 at t20 was 4.10 kPa in survivors and 3.50 kPa in nonsurvivors (95% confidence interval of difference between medians, 0.40 to 0.90 kPa; p < 0.0001). Petco2 at t20 was a better predictor of outcome than at t0.

Conclusion: Only 5% patients with Petco2 < 3.25 kPa survived to discharge. Petco2 at t20 is of value in predicting outcome from major trauma.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Air Ambulances
  • Capnography / methods*
  • Carbon Dioxide / analysis*
  • Child
  • Child, Preschool
  • Emergency Medical Services
  • Female
  • Humans
  • Infant
  • Intubation, Intratracheal
  • London / epidemiology
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Tidal Volume
  • Wounds, Nonpenetrating / complications
  • Wounds, Nonpenetrating / diagnosis*
  • Wounds, Nonpenetrating / mortality
  • Wounds, Nonpenetrating / physiopathology*
  • Wounds, Nonpenetrating / therapy


  • Carbon Dioxide