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Cardiac arrest
Mainstream and sidestream capnography give different ETCO2
Differences between Mainstream and Sidestream Capnography during Resuscitation
Resuscitation Plus · 2026-11 · Added 8 November 2026
A Spanish retrospective analysis of 23 OHCA recordings with concurrent mainstream and sidestream capnography found mainstream systematically recorded higher ETCO2 (bias 3.94 mmHg, limits of agreement -3.21 to 11.09 mmHg), though trends and abrupt rises/drops were consistently co-detected.
- Study type
- Cohort
- Design
- Retrospective device-comparison analysis of synchronized capnography waveforms
- Participants
- 23 OHCA recordings (3,460 paired ventilations)
- Main finding
- Mainstream ETCO2 bias +3.94 mmHg vs sidestream (limits of agreement -3.21 to 11.09 mmHg, proportional bias 0.0746); trends matched (-1.44 vs -1.41 mmHg/min, p=0.93); abrupt rises >=10 mmHg co-detected in 7/8 and drops in 10/15
- Caveat
- Small sample — 23 recordings from one region, so the wide limits of agreement are imprecisely estimated
- Bottom line
- Hypothesis-generating
Why it matters in Australia (High relevance). ETCO2-guided CPR quality monitoring is standard practice on Australian ambulances, and the numbers crews chart or hand over at hospital depend on which technology the monitor uses.
Learning goal
Weigh how differences between mainstream and sidestream capnography affect my interpretation of EtCO2 trends during cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 8 November 2026
- Podcast: Paramedic Papers Daily, 8 November 2026
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