Carbon dioxide (CO2) in the body is a product of metabolism. It’s produced in cells dependent on oxygen supply. During cardiac arrest, oxygen delivery to cells falls, and CO2 production decreases.
CO2 levels may be monitored at the airway through CO2 excretion, and they may be monitored in the cells through peripheral measurement. Peripheral measurement of CO2 has typically been carried out through arterial or venous analysis. Transcutaneous CO2 measurement is now a popular and useful method of providing the monitoring of CO2 levels in critically ill patients, especially pediatric patients.
Variations between the levels of CO2 excretion at the airway often indicate the state of CO2 production in the periphery. However, matters affecting venous return—such as ventilation practices and shock—can affect CO2 excretion at the airway.
This proposition for the future of cardiac arrest resuscitation provides an augmented intelligence-guided method of assessing the state of the patient’s metabolism while guiding both compression and ventilation efforts during resuscitation. It suggests the automated external defibrillator of the future could analyze CO2 transcutaneously during the resuscitation attempt.
Finally, “smart monitors” might be developed and equipped that could compare the analyses of airway CO2 and peripheral (transcutaneous) CO2 during resuscitation to optimize the outcome of these patients.