End-Tidal CO2 (ETCO2) Trends in Out-of-Hospital Cardiac Arrest

NCT07632430 | Active Not Recruiting

• 1 other identifier: ERP#14222
• Study Type: observational
• Target: 3,500
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators aim to assess the relationship between patient characteristics, prehospital treatments, and vital signs to determine if a threshold EtCO2 value, a change in EtCO2 value (final - initial), or a trend in EtCO2 (positive/negative) is a better predictor of patient survival to discharge. The secondary aim of this project is to identify significant predictors of neurologically intact patient survival as indicated by a cerebral performance category (CPC) score of 1-2.

Conditions

Cardiac Arrest, Out-Of-Hospital; Prehospital Resuscitation; End-Tidal Carbon Dioxide; Prehospital Emergency Medical Services

Outcome Measures

Primary Outcomes (1)

• Survival to Hospital Discharge

  lack of terminiation of CPR during prehospital or in hospital care

  90 days

Secondary Outcomes (1)

• Neurologically Intact Patient Survival

  90 days

Study Arms (2)

stable ETCO2

low variation in measured end-tidal CO2 during cpr; low/high threshold yet to be determined

unstable/trending ETCO2

variability in end-tidal CO2 during CPR, with or without measurable trend

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This is a retrospective cohort study. All patients encountered by emergency medical services in Oklahoma City and Tulsa experiencing an out-of-hospital cardiac arrest from Jan 1, 2024, to July 1, 2025, will be evaluated against the inclusion and exclusion criteria.

You may qualify if:

• EHR's resulting from 9-1-1 response
• Adult patients (aged 18+ at time of cardiac event)
• experiencing out-of-hospital cardiac arrest (OHCA)
• transported by an agency under OMD oversight

You may not qualify if:

• EHR's resulting from inter-facility scheduled or unscheduled medical transfers
• pediatric patients (those aged \<18 at time of incident) or unknown age
• ROSC obtained prior to arrival of EMS
• insufficient vital sign data

Sponsors & Collaborators

• Medtronic: collaborator
• Office of the Medical Director for EMS in Oklahoma City and Tulsa: lead

Study Sites (1)

Office of the Medical Director of EMS for Metropolitan Oklahoma City and Tulsa

Oklahoma City, Oklahoma, 73135, United States

Location

Related Publications (8)

• Sun KF, Poon KM, Lui CT, Tsui KL. Clinical prediction rule of termination of resuscitation for out-of-hospital cardiac arrest patient with pre-hospital defibrillation given. Am J Emerg Med. 2021 Dec;50:733-738. doi: 10.1016/j.ajem.2021.09.058. Epub 2021 Sep 29.

  PMID: 34879495 BACKGROUND

• Smida T, Menegazzi JJ, Crowe RP, Salcido DD, Bardes J, Myers B. The Association of Prehospital End-Tidal Carbon Dioxide with Survival Following Out-of-Hospital Cardiac Arrest. Prehosp Emerg Care. 2024;28(3):478-484. doi: 10.1080/10903127.2023.2262566. Epub 2023 Oct 6.

  PMID: 37751228 BACKGROUND

• Richardson M, Moulton K, Rabb D, Kindopp S, Pishe T, Yan C, Akpinar I, Tsoi B, Chuck A. Capnography for Monitoring End-Tidal CO2 in Hospital and Pre-hospital Settings: A Health Technology Assessment [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2016 Mar. Available from http://www.ncbi.nlm.nih.gov/books/NBK362374/

  PMID: 27227208 BACKGROUND

• Kudu E, Danis F, Karaca MA, Erbil B. Usability of EtCO2 values in the decision to terminate resuscitation by integrating them into the TOR rule (an extended TOR rule): A preliminary analysis. Heliyon. 2023 Sep 13;9(9):e19982. doi: 10.1016/j.heliyon.2023.e19982. eCollection 2023 Sep.

  PMID: 37809508 BACKGROUND

• Hatlestad D. Capnography as a predictor of the return of spontaneous circulation. Emerg Med Serv. 2004 Aug;33(8):75-80; quiz 115.

  PMID: 15368978 BACKGROUND

• Hambelton C, Wu L, Smith J, Thompson K, Neth MR, Daya MR, Jui J, Lupton JR. Utility of end-tidal carbon dioxide to guide resuscitation termination in prolonged out-of-hospital cardiac arrest. Am J Emerg Med. 2024 Mar;77:77-80. doi: 10.1016/j.ajem.2023.11.030. Epub 2023 Dec 7.

  PMID: 38104387 BACKGROUND

• Eckstein M, Hatch L, Malleck J, McClung C, Henderson SO. End-tidal CO2 as a predictor of survival in out-of-hospital cardiac arrest. Prehosp Disaster Med. 2011 Jun;26(3):148-50. doi: 10.1017/S1049023X11006376.

  PMID: 22107764 BACKGROUND

• Dudaryk R, Bodzin DK, Ray JJ, Jabaley CS, McNeer RR, Epstein RH. Low End-Tidal Carbon Dioxide at the Onset of Emergent Trauma Surgery Is Associated With Nonsurvival: A Case Series. Anesth Analg. 2017 Oct;125(4):1261-1266. doi: 10.1213/ANE.0000000000002283.

  PMID: 28704248 BACKGROUND

MeSH Terms

Conditions

Out-of-Hospital Cardiac Arrest

Condition Hierarchy (Ancestors)

Heart Arrest; Heart Diseases; Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Biostatisitican

Study Record Dates

• First Submitted: June 2, 2026
• First Posted: June 8, 2026
• Study Start: January 1, 2024
• Primary Completion: July 1, 2025
• Study Completion (Estimated): September 30, 2026
• Last Updated: June 9, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)