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Original Research

Open Access

Relationship between mean arterial pressure and end-tidal partial pressure of carbon dioxide during hemorrhagic shock and

volume resuscitation


1,The Center for Emergency Medicine Maribor

DOI: 10.22514/SV41.042009.5 Vol.4,Issue 1,April 2009 pp.24-26

Published: 09 April 2009

*Corresponding Author(s): STEFEK GRMEC E-mail:


Objectives. We examined the relationship between partial end-tidal CO2 (pet) and mean arterial pressure in patients with traumatic hemorrhagic shock, who were receiving constant minute ventilation.

Methods. In 61 patients we continuously measured pet CO2 with a capnograph, direct arterial pressure via a cannula, oxygen levels via pulse oximetry and body temperature.

Results. We observed significant changes in pet CO2 (increase) after volume resuscitation and a quantitative linear relati-onship between pet CO2 and mean arterial pressure.

Conclusions. Partial end-tidal CO2 can be used as a reliable non-invasive monitoring device in patients with hemorrhagic shock when minute ventilation is relatively constant. The monitoring of pet CO2 might also be a useful guide for volume resuscitation in hemorrhagic shock, especially in the pre-hospital setting.


end- tidal CO2, mean arte-rial pressure, hemorrhagic shock, relationship

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STEFEK GRMEC,MIRJAM GOLUB,ALINA JELATANCEV. Relationship between mean arterial pressure and end-tidal partial pressure of carbon dioxide during hemorrhagic shock andvolume resuscitation. Signa Vitae. 2009. 4(1);24-26.


1. West JB. Ventilation-perfusion relationship. Am Rev Respir Dis 1977;116:919–43.

2. Grmec Š, Klemen P. Does the end-tidal carbon dioxide (Et CO2) concentration have prognostic value during out-of-hospital cardiac arrest. Eur J Emerg Med 2001;8:263–9.

3. Grmec Š, Kupnik D. Does the Mainz Emergency Evaluation Scoring (MEES) in combination with capnometry (MEESc) help in the prognosis of outcome from cardiopulmonary resuscitation in a prehospital setting. Resuscitation 2003;58:89–96.

4. Isserles SA, Breen PH. Can changes in end-tidal pet CO2 measure changes in cardiac out-put? Anesth Analg 1991;73:808–14.

5. Ornato JP, Garnet AR, Glauser FL. Relationship between cardiac output and the end-tidal carbon dioxide tension. Ann Emerg Med 1990;19:1104–6.

6. Weil MH, Bisera J, Trevino RP, Rackow EC. Cardiac output and end-tidal carbon dioxide. Crit Care Med 1985;13:907-9.

7. Jin X, Weil MH, Tang W, Povoas H, Pernat A, Xie J, et al. End-tidal carbon dioxide as a noninvasive indicator of cardiac index during circu-latory shock. Crit Care Med 2000;28:2415–9.

8. Guzman JA, Lacoma FJ, Najari A, Kruse JA. End-tidal partial pressure of carbon dioxide as a noninvasive indicator of systemic oxygen supply dependency during hemorrhagic shock and resuscitation. Shock 1997;8(6):427–31.

9. Dubin A, Murias G, Estenssoro E, Canales H, Sottile P, Badie J, et al. End-tidal CO2 pressures determinants during hemorrhagic shock. Intensive Care Med 2000;26(11):1619–23.

10. Dubin A, Silva C, Calvo G, Valli J, Faruna O, Estenssoro E, et al. End-tidal CO2 pressure in the monitoring of cardiac output during canine hemorrhagic shock. J Crit Care 1990;5:42–6.

11. Tyburski JG, Collinge JD, Wilson RF, Carlin AM, Albaran RG, Steffes CP. (2002) End-tidal CO2 derived values during emergency trauma surgery correlated with outcome: A prospective study. J Trauma 2002;53:738–43.

12. Tyburski JG, Carlin AM, Harvey EHS, Steffes C, Wilson RF. End-tidal CO2 – arterial CO2 differences: a useful intraoperative mortality marker in trauma surgery. J Trauma 2003;55:892–7.

13. Copes WS, Champion HR, Sacco WJ, Lawnich MM, Keast SL, Bain LW. The injury severity score revised. J Trauma 1988;28:69-77.

14. Champion HR, Sacco WJ, Carnazzo AJ, Copes WS, Fouty WJ. Trauma Score. Crit Care Med 1981;9:672–6.

15. Ward KR, Yealy MD. End Tidal Carbon Dioxide Monitoring in Emergency Medicine, Part 1: Basic Principles. Acad Emerg Med 1998;5:628–38.

16. Falk JL, Rackow EC, Weil MH. End-tidal carbon dioxide concentration during cardiopulmonary resuscitation. N Engl J Med 1988;318:607–11.

17. Sanders AB, Kern K, Otto CW, Milander MM, Ewy GA. End-tidal carbon dioxide monitoring during cardiopulmonary resucitation. A pro-gnostic indicator for survival. J Am Med Assoc 1989;262:1347–51.

18. Gazmuri RJ, von Planta M, Weil MH, Rackow EC. Arterial pCO2 as an indicator of systemic perfusion during cardiopulmonary resuscitation. Crit Care Med 1989;17:237–40.

19. Trillo G, von Planta M, Kette F. Et CO2 monitoring during low flow states: clinical aims and limitis. Resuscitation 1994;27:1–8.

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