What does a sudden rise in capnography indicate during resuscitation?

A sudden rise in capnography during resuscitation indicates the return of spontaneous circulation (ROSC). This increase in end-tidal carbon dioxide (EtCO2) levels suggests that blood is being effectively circulated through the lungs again, allowing for the exhalation of carbon dioxide. When the heart begins to pump effectively, the perfusion to the lungs improves, leading to an increase in the amount of carbon dioxide being transported back to the lungs from the tissues and ultimately expelled.

In the context of resuscitation, monitoring capnography is crucial as it provides real-time feedback about the effectiveness of chest compressions and increases in EtCO2 can signal that the efforts to revive the patient are successful, leading to the potential restoration of circulation. Other physiological changes and issues may cause fluctuations in capnography readings, but a sudden and sustained rise is closely associated with ROSC, which is a critical milestone in the resuscitation process.