In the context of cardiac arrest, what is a sign of potential return of spontaneous circulation?

In the context of cardiac arrest, a rise in end-tidal carbon dioxide (EtCO2) is a significant indicator of potential return of spontaneous circulation (ROSC). When circulation is restored, the blood flow increases to the lungs, facilitating gas exchange and improving the elimination of carbon dioxide. Therefore, an increasing EtCO2 level suggests that the heart may be pumping blood again and that there is improved perfusion and ventilation occurring.

This measure is closely monitored in resuscitation efforts, as EtCO2 levels greater than 20 mmHg are often associated with a better chance of ROSC. Conversely, lower EtCO2 readings typically indicate poor circulation or insufficient blood flow to the lungs, suggesting that effective resuscitation may need to continue.

Other options, while important in different contexts, do not specifically indicate the likelihood of ROSC in the same way. For example, a rising heart rate might occur for various reasons and may not necessarily reflect effective circulation. Meanwhile, increased blood pressure can occur as a response to medications or other interventions, not specifically directly indicating ROSC. Improved SpO2 is valuable for assessing oxygenation but may not correlate as directly with the return of spontaneous circulation as EtCO2 does.