Trends and variation in use of end-tidal carbon dioxide during in-hospital cardiac arrest: an observational cohort study
By
Luke Andrea
Joshua M Kimbrell
Shilpa Kolli
Michelle M Nassal
Ari Moskowitz
June 18, 2026
Clinical Scorecard: Patterns and Variability in End-Tidal Carbon Dioxide Utilization During In-Hospital Cardiac Arrest: An Observational Cohort Analysis
At a Glance
Category Detail
Condition In-Hospital Cardiac Arrest Key Mechanisms End-tidal carbon dioxide (EtCO2) is used for airway confirmation and monitoring cardiopulmonary resuscitation (CPR). Target Population Adults (age ≥ 18 years) experiencing in-hospital cardiac arrest. Care Setting In-hospital settings across multiple hospitals.
Key Highlights
92.6% of new airways were confirmed with EtCO2 from 2019-2023. 35.3% of cardiac arrests utilized EtCO2 for CPR monitoring during the same period. Little variation in EtCO2 use for airway confirmation across hospitals. High variability in EtCO2 application for CPR monitoring across hospitals. EtCO2 is a noninvasive surrogate for cardiac output during CPR. Guideline-Based Recommendations
Diagnosis
Use waveform capnography for advanced airway confirmation due to high sensitivity and specificity. Management
Monitor EtCO2 to optimize CPR and assess the quality of resuscitation. Monitoring & Follow-up
Persistently low EtCO2 (<10 mmHg) during CPR indicates unsuccessful resuscitation. Risks
Failure to monitor EtCO2 during CPR may lead to missed opportunities for optimizing resuscitation efforts. Patient & Prescribing Data
Adults with in-hospital cardiac arrest.
EtCO2 is recommended for both confirming airway placement and monitoring CPR effectiveness.
Clinical Best Practices
Implement routine use of EtCO2 for airway confirmation in all in-hospital cardiac arrests. Encourage consistent documentation of EtCO2 use for CPR monitoring. Related Resources & Content
