Cardiac arrest & 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

ResuscitationPublished Retrospective cross-sectional study

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

%

OutcomeCCSVManually
Hospital admission status
Admission with ROSC24— not stated in the abstract
Admission under ongoing CPR34— not stated in the abstract
Died on scene— not stated in the abstract59

— not stated 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:10.1016/j.resuscitation.2025.110764

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