Comprehensive Summary
This prospective, quasi-experimental study evaluated how different ventilation techniques affect outcomes in adults with non-traumatic out-of-hospital cardiac arrest (OHCA). Between April 2021 and September 2024, patients were assigned in a prospective quasi-experimental fashion to one of three ventilation strategies: chest compression–synchronized ventilation (CCSV), intermittent positive-pressure ventilation (IPPV), or standard manual bag ventilation. Among the 521 patients analyzed, those managed with CCSV achieved a higher rate of return of spontaneous circulation (ROSC) than those receiving bag ventilation (61% vs 49.3%) and showed a higher rate of survival with favorable neurological outcome (16% vs 9.4%). Arterial blood gas analysis revealed higher pH and lower PaCO₂ among patients receiving mechanical ventilation, with CCSV also associated with higher PaO₂ values. Although most differences did not reach statistical significance, the data suggest that mechanical ventilation, particularly CCSV, may improve key physiologic parameters and patient outcomes.
Outcomes and Implications
These findings highlight the potential advantages of mechanical ventilation over manual bagging in OHCA, an area where high-quality evidence remains limited. If validated in larger randomized trials, CCSV could provide more consistent ventilation while preserving circulation during chest compressions, potentially improving survival with favorable neurological outcomes.Widespread adoption would require confirmatory evidence, dedicated training, and equipment availability, but CCSV may ultimately play an important role in resuscitation practice.