Acute cardiac care & resuscitation
Mechanical ventilation with ten versus twenty breaths per minute during cardio-pulmonary resuscitation for out-of-hospital cardiac arrest: A randomised controlled trial
- terminated early
- Terminated early due to slow recruitment
Authors' conclusion
20 instead of 10 mechanical ventilations during CPR increase ventilation volumes per minute, but do not improve CO2 washout, acidaemia, oxygenation, or rate of ROSC.
Study context
- Population
- Adults with out-of-hospital cardiac arrest (OHCA) receiving cardio-pulmonary resuscitation (CPR) with advanced airway management and mechanical ventilation by a prehospital physician response unit23 per group
- Participants
- 46 adults
- Comparison
- Mechanical ventilation at 20 vs 10 breaths per minute during CPR
- 20 min-1n = 23
- 10 min-1n = 23reference
- Primary endpoint
- Effects on ventilation, acid-base status and outcomes
Methodological detailssingle-centre
- Single-centre
Primary result
As reported in the abstract
Ventilation
| Group | Expiratory minute volume | Mean airway pressure | Peak airway pressure |
|---|---|---|---|
| 20 min-1 | 8.8 (6.8-9.9) litres | 11.6 (9.8-13.6) mmHg | 42.5 (36.5-45.9) mmHg |
| 10 min-1 | 4.9 (4.2-5.7) litres | 9.8 (8.5-12.0) mmHg | 41.4 (32.2-51.7) mmHg |
Expiratory minute volume
20 min-18.8 (6.8-9.9) litres
10 min-14.9 (4.2-5.7) litres
Mean airway pressure
20 min-111.6 (9.8-13.6) mmHg
10 min-19.8 (8.5-12.0) mmHg
Peak airway pressure
20 min-142.5 (36.5-45.9) mmHg
10 min-141.4 (32.2-51.7) mmHg
- 20 min-1 vs 10 min-1: P < 0.001 — expiratory minute volume
- 20 min-1 vs 10 min-1: P = 0.496 — mean airway pressure
- 20 min-1 vs 10 min-1: P = 0.895 — peak airway pressure
Further findings
| Outcome | P value |
|---|---|
| ROSC12 of 23 (52%) vs. 11 of 23 (48%); no difference | P = 0.768 |
| pHMedian 6.83 (6.65-7.05) vs. 6.89 (6.80-6.97); no difference | P = 0.913 |
| pCO2Median 78 (51-105) vs. 86 (73-107) mmHg; no difference | P > 0.999 |
Original publication
Mechanical ventilation with ten versus twenty breaths per minute during cardio-pulmonary resuscitation for out-of-hospital cardiac arrest: A randomised controlled trial. Resuscitation. Published 15 March 2023. doi:10.
Summarised from the published abstract; every number is checked against it