da Rosa Decker Sérgio Renato, Marzzani Lucas Emanuel, de Ferreira Pedro Rotta, Rosa Paulo Ricardo Mottin, Brauner Janete Salles, Rosa Regis Goulart, Bertoldi Eduardo Gehling
Programa de Pós-graduação em Cardiologia e Ciências Cardiovasculares, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
Serviço de Medicina Interna, Hospital Moinhos de Vento, Porto Alegre, Brazil.
Am Heart J Plus. 2024 Feb 29;40:100373. doi: 10.1016/j.ahjo.2024.100373. eCollection 2024 Apr.
To evaluate the cost-effectiveness of EtCO monitoring during in-hospital cardiorespiratory arrest (CA) care outside the intensive care unit (ICU) and emergency room department.
We performed a cost-effectiveness analysis based on a simple decision model cost analysis and reported the study using the CHEERS checklist. Model inputs were derived from a retrospective Brazilian cohort study, complemented by information obtained through a literature review. Cost inputs were gathered from both literature sources and contacts with hospital suppliers.
The analysis was carried out from the perspective of a tertiary referral hospital in a middle-income country.
The study population comprised individuals experiencing in-hospital CA who received cardiopulmonary resuscitation (CPR) by rapid response team (RRT) in a hospital ward, not in the ICU or emergency room department.
Two strategies were assumed for comparison: one with an RRT delivering care without capnography during CPR and the other guiding CPR according to the EtCO waveform.
Incremental cost-effectiveness rate (ICER) to return of spontaneous circulation (ROSC), hospital discharge, and hospital discharge with good neurological outcomes.
The ICER for EtCO monitoring during CPR, resulting in an absolute increase of one more case with ROSC, hospital discharge, and hospital discharge with good neurological outcome, was calculated at Int$ 515.78 (361.57-1201.12), Int$ 165.74 (119.29-248.4), and Int$ 240.55, respectively.
In managing in-hospital CA in the hospital ward, incorporating EtCO2 monitoring is likely a cost-effective measure within the context of a middle-income country hospital with an RRT.
评估在重症监护病房（ICU）和急诊科以外的医院内心肺复苏（CA）护理期间进行呼气末二氧化碳（EtCO）监测的成本效益。
我们基于简单决策模型成本分析进行了成本效益分析，并使用CHEERS清单报告了该研究。模型输入数据来自一项巴西回顾性队列研究，并辅以通过文献综述获得的信息。成本数据从文献来源和与医院供应商的联系中收集。
分析是从中等收入国家的一家三级转诊医院的角度进行的。
研究人群包括在医院病房接受快速反应小组（RRT）进行心肺复苏（CPR）的院内CA患者，而非在ICU或急诊科。
假设两种策略进行比较：一种是RRT在CPR期间不使用二氧化碳图进行护理，另一种是根据EtCO波形指导CPR。
恢复自主循环（ROSC）、出院以及出院时具有良好神经功能结局的增量成本效益比（ICER）。
CPR期间EtCO监测的ICER，即导致ROSC、出院以及出院时具有良好神经功能结局的病例绝对增加一例，分别计算为515.78国际元（361.57 - 1201.12）、165.74国际元（119.29 - 248.4）和240.55国际元。
在医院病房管理院内CA时，在拥有RRT的中等收入国家医院背景下，纳入EtCO2监测可能是一种具有成本效益的措施。
