Utility of Non-invasive Monitoring of Exhaled Carbon Dioxide and Perfusion Index in Adult Patients in the Emergency Department
Authors: Raúl López-Izquierdo, Daniel Zalama-Sánchez, de Salamanca Gambara Rodrigo Enríquez, Rodríguez Ana Ramos, Millán Laura Fadrique, Muñoz Mario Rodil, Rodríguez Virginia Carbajosa, García Rubén Pérez, Ancor Sanz-García, Carlos Del Pozo Vegas, Francisco Martín-Rodríguez
Published in: American Journal of Emergency Medicine, 2024 February 21
Conclusions:
- The study demonstrated that PI and respiratory rate are independently associated with in-hospital mortality, indicating their value as predictive parameters.
- Both PI and ETCO2, along with standard vital signs, contribute to improved prognostic performance in assessing the risk of in-hospital mortality among ED patients.
Methods:
- Conducted as a multicenter, prospective cohort study in two tertiary hospitals in Spain from October 2022 to June 2023.
- Adult patients with acute diseases requiring continuous monitoring in the ED were included.
- The primary outcome was all-cause in-hospital mortality.
- Data on demographics, vital signs, ETCO2, and PI were collected and analyzed.
Results:
- 687 patients were included, with an in-hospital mortality rate of 6.8%.
- Median age was 79 years (IQR: 69-86), and 63.3% were male.
- Median ETCO2 values: 30 mmHg (26-35) in survivors vs. 23 mmHg (16-30) in nonsurvivors (p = 0.001).
- Median PI values: 4.7% (2.8-8.1) in survivors vs. 2.5% (0.98-4.4) in nonsurvivors (p < 0.001).
- Best predictive model for in-hospital mortality included age, respiratory rate, and PI, with an AUC of 0.840 (95% CI: 0.795-0.886).