Capnography during pediatric CPR is used for which primary purposes?

• A. To monitor oxygen saturation during CPR
• B. To confirm endotracheal tube placement, monitor CPR quality, and assess for ROSC via ETCO2 changes
• C. To measure blood pressure
• D. Not used during pediatric CPR

Answer: (A)

Capnography measures end-tidal CO2, which gives real-time information about ventilation and perfusion during CPR. This makes it particularly useful for three main tasks. First, it helps confirm endotracheal tube placement: a detectable CO2 waveform indicates that air is reaching the lungs through the tube, confirming tracheal, not esophageal, placement. Second, it provides feedback on CPR quality: higher and more consistent ETCO2 levels generally reflect better chest compressions and greater effective pulmonary blood flow, while persistently low ETCO2 suggests suboptimal compressions. Third, it helps detect return of spontaneous circulation: a sudden, sustained rise in ETCO2 or a stable higher level after compressions can indicate ROSC.

Oxygen saturation, on the other hand, is tracked with pulse oximetry, not capnography, so capnography is not primarily about measuring oxygenation. It also does not directly provide blood pressure, though blood pressure can be monitored separately during resuscitation.