Successful Recording of End-tidal Concentration of Oxygen and Carbon dioxide at Return of Spontaneous Circulation: A Case Report of Cardiopulmonary Resuscitation

• Published in: Nihon Rinshō Masui Gakkai shi Vol. 14; no. 1; pp. 77 - 81
• Main Authors: KIMURA, Tetsu, INOMATA, Shinichi, YAGUCHI, Yuichi, NISHIJIMA, Yukiko, WATANABE, Seiji, SUGA, Akihiko
• Format: Journal Article
• Language: English
• Published: THE JAPAN SOCIETY FOR CLINICAL ANESTHESIA 1994
• ISSN: 0285-4945; 1349-9149
• DOI: 10.2199/jjsca.14.77

We successfully recorded oxygen uptake and carbon dioxide washout curves before and after return of spontaneous circulation. We introduce the case and discuss the implication of the unprecedented recording. A 67-year-old male patient underwent resection of the rectum under epidural and light sevoflurane anesthesia. During the emergence phase of anesthesia, coincidentally wide QRS waves were observed in the EKG monitor, and then ventricular fibrillation (Vf) took place. External cardiac massage was immediately started. The first countershock successfully defibrillated the heart, but a few minutes later Vf occured again. About 30 minutes after the first fibrillation onset, intra-aortic balloon pumping (IABP) was started via the right femoral artery. The fourth defibrillation attempt 10 minutes later on IABP successfully defibrillated the heart. Immediately after the return of spontaneous circulation, the patient responded well enough to all verbal commands. He was tentatively diagnosed as having had a coronary spasm. At the 45-minute point after the first fibrillation, monitoring of ETCO2 and ETO2 was started using a Raman scattering gas monitor (RASCALTM). When spontaneous circulation returned, ETCO2 value increased from 10mmHg to 60mmHg, and ETO2 value abruptly decreased from almost 100% to 90%.