For patients undergoing resuscitation, what ETCO2 value indicates ineffective CPR after 20 minutes of ACLS?

An end-tidal carbon dioxide (ETCO2) value of less than 10 mmHg after 20 minutes of advanced cardiac life support (ACLS) indicates ineffective cardiopulmonary resuscitation (CPR). This low level suggests that there is inadequate blood flow and ventilation occurring during resuscitation efforts.

During CPR, effective chest compressions should produce a sufficient amount of blood flow to the lungs, allowing for the adequate exchange of gases. A higher ETCO2 value reflects better circulation and the ability of the lungs to expel carbon dioxide. Therefore, a value below 10 mmHg is a critical indicator that the CPR efforts are not adequately perfusing the patient's lungs, and resuscitation is unlikely to be successful.

Maintaining awareness of ETCO2 levels during resuscitation can help guide providers in assessing the effectiveness of the CPR being performed, and prompt reevaluation of the technique or interventions being used if those values are not adequate. This knowledge is essential for optimizing patient outcomes in emergency situations.