Acute cardiac care & resuscitation
Influence of different ventilation strategies during cardiopulmonary resuscitation on the return of spontaneous circulation in out-of-hospital cardiac arrest: a retrospective study from the German resuscitation registry
Main finding · ROSCResult — go to the resultDeviation from expected ROSC +2.7 %Authors' conclusion
Respirator controlled ventilation with IPPV modestly but significantly exceeded expected ROSC rates in patients with non-traumatic OHCA. CCSV, the mode designed specifically for ventilation during CPR, does not seem to be superior to manual bag-valve ventilation.
Study context
- Population
- Adults (≥18 years) with non-traumatic out-of-hospital cardiac arrest (OHCA) intubated during CPR with documented ventilation strategy, March 2016–March 2023
- Participants
- 3,195 adults
- Exposure
- Intermittent Positive Pressure Ventilation (IPPV) vs Chest Compression Synchronized Ventilation (CCSV) vs biphasic positive airway pressure (BIPAP) vs manual bag-valve ventilation during CPR
- IPPVn = 1,865
- CCSVn = 194
- BIPAPn = 81
- Manuallyn = 1,055
- Outcome
- ROSC observed vs expected ROSC by RACA score
Methodological detailsregistry-based (German Resuscitation Registry)
- Registry-based (German Resuscitation Registry)
Main finding
ROSC
Deviation from expected return of spontaneous circulation (ROSC)
+2.7 %
P = 0.0005
By group
As reported in the abstract
Observational data: associations, not effects.
Secondary outcomes
%
| Outcome | IPPV | CCSV | BIPAP | Manually | |
|---|---|---|---|---|---|
| Hospital admission status | |||||
| Admission with ROSC | Not reported in the abstract | 24 | Not reported in the abstract | Not reported in the abstract | IPPV, BIPAP, Manually: not reported in the abstract |
| Admission under ongoing CPR | Not reported in the abstract | 34 | Not reported in the abstract | Not reported in the abstract | IPPV, BIPAP, Manually: not reported in the abstract |
| Died on scene | Not reported in the abstract | Not reported in the abstract | Not reported in the abstract | 59 | IPPV, CCSV, BIPAP: not reported in the abstract |
Original publication
Influence of different ventilation strategies during cardiopulmonary resuscitation on the return of spontaneous circulation in out-of-hospital cardiac arrest: a retrospective study from the German resuscitation registry. Resuscitation. Published 7 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it