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| Name | Class |
|---|---|
| Ruhr University of Bochum | OTHER |
| Bielefeld University | OTHER |
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The study investigates the influence of non-synchronized bag-device-ventilation and intermittent positive pressure ventilation (IPPV), as recommended in the current resuscitation guidelines of the European Resuscitation Concil (tidal Volume (Vt) = 5-6 mL/kg body weight, respiratory rate = 10 min-1) and Chest Compression Synchronized Ventilation (pInsp = 40 mbar; respiratory rate = chest compression rate) with regard to achieving a sufficient tidal volume and the tightness of various supraglottic airway devices (laryngeal mask, i-Gel-laryngeal mask, laryngeal tube) and endotracheal intubation.
The European Resuscitation Council (ERC) guidelines for cardiopulmonary resuscitation (CPR) recommend uninterrupted chest compressions and continuous ventilation as soon as a patient is endotracheally intubated or a supraglottic airway (SGA) is positioned.
Recently, SGAs have been adopted by emergency medical services worldwide as the primary tool for airway management during CPR. SGAs offer limited protection against aspiration compared to endotracheal intubation (ETI) and may increase the risk of aspiration. A new ventilation mode (Chest Compression Synchronized Ventilation [CCSV]) is now available for resuscitation with uninterrupted chest compressions.
The study investigates the influence of non-synchronized bag-device-ventilation, intermittent positive pressure ventilation (IPPV), as recommended in the current resuscitation guidelines of the ERC (Vt = 5-6 mL/kg bw, AF = 10 min-1) and CCSV (pInsp = 40 mbar; RR = chest compression rate) with regard to achieving a sufficient tidal volume and the tightness of various SGA (laryngeal mask, iGel, laryngeal tube) and endotracheal intubation.
Gender, age, height and weight are documented (external post-mortem examination). The respective body donor is randomly assigned to a group. The grouping determines the order in which the means of airway management (SGA, ETI) are used.
Initial airway management is performed with an ETI with blockage of 30 mmH2O). The body donor is then bronchoscoped. A gastric tube is placed and the pressure probe to be used is calibrated if necessary. Positive pressure ventilation (pInsp = 40 mbar, positive end-expiratory pressure (PEEP) = 12 mbar, frequency = 10 min-1) is performed for 2 minutes to recruit the lungs. Vt is documented.
Mechanical cardiopulmonary resuscitation (CPR) is then performed for minutes (4 cycles) using the mechanical chest compression device in accordance with ERC 2015. Ventilation pressure and flow curves are continuously recorded by the respirator (Medumat Standard², Weinmann GmbH). Leaks are detected via the automatically initiated ventilation curves, measured and recorded by the ventilator. Ventilation takes place for 4 minutes with bad-device-ventilation, 4 minutes in IPPV mode and 4 minutes in CCSV mode. At the end of the two cycles, the body donor is intubated with one of the remaining airway devices, and the lungs are recruited again and mechanical CPR is performed again for 12 minutes using the 3 ventilation modes.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| IPPV | Active Comparator | Intermittend-Positive-Pressure-Ventilation |
|
| CCSV | Active Comparator | Chest Compression Synchronized Ventilation |
|
| Bag-Device-Ventilation | Active Comparator | Ventilation with a Ventilation Bag |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Endotracheal Intubation | Other | Ventilation with an endotracheal tube |
|
| Measure | Description | Time Frame |
|---|---|---|
| Expiratory Volume with different Airway Devices in IPPV | Mean expiratory Volume with different Airway Devices in IPPV | After beginning of ventilation up to 4 minutes each device |
| Ventilation Pressure with different Airway devices in CCSV | After beginning of ventilation up to 4 minutes each device |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| JWK Minden | Minden | North Rhine-Westphalia | 32429 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 41345669 | Derived | Lohmann J, Brand-Saberi B, Ullrich M, Gelashvili T, Hoyer A, Kolaparambil Varghese LJ, Kuehn V, Neuhaus C, Schneider C, Trenkel J, Hinkelbein J, Jansen G. Influence of different airway devices on intra-arrest ventilation during bag-valve-device ventilation - a prospective randomized controlled cadaver study. Crit Care. 2025 Dec 5;29(1):519. doi: 10.1186/s13054-025-05713-z. | |
| 40907692 |
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| ID | Term |
|---|---|
| D006323 | Heart Arrest |
| D053120 | Respiratory Aspiration |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D012120 | Respiration Disorders |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D007442 | Intubation, Intratracheal |
| D017214 | Laryngeal Masks |
| ID | Term |
|---|---|
| D058109 | Airway Management |
| D013812 | Therapeutics |
| D007440 | Intubation |
| D008919 | Investigative Techniques |
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Randomized crossover design
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| Laryngeal tube | Other | Ventilation with an laryngeal tube |
|
| Laryngeal mask | Other | Ventilation with an laryngeal mask |
|
| I-Gel-Laryngeal Mask | Other | Ventilation with an I-Gel-laryngeal mask |
|
| Derived |
| Gelashvili T, Brand-Saberi B, Darvishali M, Hoyer A, Kolaparambil Varghese LJ, Kuehn V, Lohmann J, Neuhaus C, Schneider C, Trenkel J, Hinkelbein J, Jansen G. Efficacy of supraglottic airway devices in chest compression synchronized ventilation during continuous resuscitation: a prospective randomized cross-over cadaver study. Resuscitation. 2025 Nov;216:110795. doi: 10.1016/j.resuscitation.2025.110795. Epub 2025 Sep 2. |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008397 |
| Masks |
| D011482 | Protective Devices |
| D004864 | Equipment and Supplies |
| D000067393 | Personal Protective Equipment |
| D008420 | Manufactured Materials |
| D013676 | Technology, Industry, and Agriculture |