Tamar Gelashvili, Beate Brand-Saberi, Mahsa Darvishali, Annika Hoyer, Lydia Johnson Kolaparambil Varghese, Vanessa Kuehn, Jonas Lohmann, Christian Neuhaus, Claudia Schneider, Justin Trenkel, Jochen Hinkelbein, Gerrit Jansen
{"title":"声门上气道装置在持续复苏期间胸压同步通气中的疗效：一项前瞻性随机交叉尸体研究。","authors":"Tamar Gelashvili, Beate Brand-Saberi, Mahsa Darvishali, Annika Hoyer, Lydia Johnson Kolaparambil Varghese, Vanessa Kuehn, Jonas Lohmann, Christian Neuhaus, Claudia Schneider, Justin Trenkel, Jochen Hinkelbein, Gerrit Jansen","doi":"10.1016/j.resuscitation.2025.110795","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the efficacy of Chest-Compression-Synchronized-Ventilation (CCSV) using supraglottic airway devices (SGA) compared to tracheal intubation (TI) for ventilation during continuous resuscitation.</p><p><strong>Methods: </strong>In this cross-over study, the lungs of adult Thiel-embalmed cadavers were initially recruited using TI. Subsequently, various SGA (Laryngeal-Mask = Ambu®AuraGain™, Laryngeal-Tube = LTS-D®, i-gel-Laryngeal-Mask = I-GEL®) and TI were applied in randomized order during continuous chest compressions. CCSV was delivered with a CCSV-Pressure (pCCSV) = 40 mbar, PEEP = 3 mbar, respiratory-rate (RR) synchronized with the chest compression rate. The primary endpoint was achieving a pCCSV = 40 ± 3 mbar. Secondary endpoints included pCCSV, expiratory tidal (V<sub>te</sub>) 1 ml/kgBW and leakage volumes (V<sub>leak</sub>). Logistic regression models with random intercepts were used for the primary outcome, and linear mixed models were applied for secondary outcomes.</p><p><strong>Results: </strong>Eleven cadavers were included. While two(18 %) were successfully ventilated with all airway types, three(27 %) could only be ventilated with an TI. Two cadavers(18 %) could not be sufficiently ventilated with any of the airway devices including TI. When comparing TI and SGA, for TI a greater chance of reaching the target corridor of pCCSV (Odds Ratio(OR) = 1.87; 95 %-Confidence-Interval(95 %CI) = [0.91-3.83]; P = 0.0864) and a higher pCCSV was observed (regression-coefficient(RC) = 2.99 mbar; 95 %CI = [1.63-4.35]; p < 0.0001), along with a higher V<sub>te</sub> (RC = 42.42 ml; 95 %CI = [32.07-52.27]; p < 0.0001), and a lower V<sub>leak</sub> (RC = -55.03 %; 95 %CI = [-62.92-47.15]; p < 0.0001). In comparisons among the individual SGA, lower pCCSV-values were observed for Ambu®AuraGain™ versus I-GEL® (RC = -2.58 mbar; 95 %CI = [-4.04--1.13]; p = 0.0006), Ambu®AuraGain™ versus LTS-D® (RC = -1.73 mbar; 95 %CI = [-3.18--0.27]; p = 0.0204), and LTS-D® versus I-GEL® (RC = -0.86 mbar; 95 %CI = [-2.30-0.59]; p = 0.2434).</p><p><strong>Conclusion: </strong>SGA were associated with a lower likelihood of reaching the target range of pCCSV, lower V<sub>te</sub>, and higher V<sub>leak</sub>. Regardless the airway device, CCSV-failure is possible emphasizing the need for vigilant respiratory monitoring.</p><p><strong>Registration: </strong>URL: https://www.</p><p><strong>Clinicaltrials: </strong>gov. Unique identifier number: NCT06306898.</p>","PeriodicalId":21052,"journal":{"name":"Resuscitation","volume":" ","pages":"110795"},"PeriodicalIF":4.6000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy of supraglottic airway devices in chest compression synchronized ventilation during continuous resuscitation: a prospective randomized cross-over cadaver study.\",\"authors\":\"Tamar Gelashvili, Beate Brand-Saberi, Mahsa Darvishali, Annika Hoyer, Lydia Johnson Kolaparambil Varghese, Vanessa Kuehn, Jonas Lohmann, Christian Neuhaus, Claudia Schneider, Justin Trenkel, Jochen Hinkelbein, Gerrit Jansen\",\"doi\":\"10.1016/j.resuscitation.2025.110795\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aimed to evaluate the efficacy of Chest-Compression-Synchronized-Ventilation (CCSV) using supraglottic airway devices (SGA) compared to tracheal intubation (TI) for ventilation during continuous resuscitation.</p><p><strong>Methods: </strong>In this cross-over study, the lungs of adult Thiel-embalmed cadavers were initially recruited using TI. Subsequently, various SGA (Laryngeal-Mask = Ambu®AuraGain™, Laryngeal-Tube = LTS-D®, i-gel-Laryngeal-Mask = I-GEL®) and TI were applied in randomized order during continuous chest compressions. CCSV was delivered with a CCSV-Pressure (pCCSV) = 40 mbar, PEEP = 3 mbar, respiratory-rate (RR) synchronized with the chest compression rate. The primary endpoint was achieving a pCCSV = 40 ± 3 mbar. Secondary endpoints included pCCSV, expiratory tidal (V<sub>te</sub>) 1 ml/kgBW and leakage volumes (V<sub>leak</sub>). Logistic regression models with random intercepts were used for the primary outcome, and linear mixed models were applied for secondary outcomes.</p><p><strong>Results: </strong>Eleven cadavers were included. While two(18 %) were successfully ventilated with all airway types, three(27 %) could only be ventilated with an TI. Two cadavers(18 %) could not be sufficiently ventilated with any of the airway devices including TI. When comparing TI and SGA, for TI a greater chance of reaching the target corridor of pCCSV (Odds Ratio(OR) = 1.87; 95 %-Confidence-Interval(95 %CI) = [0.91-3.83]; P = 0.0864) and a higher pCCSV was observed (regression-coefficient(RC) = 2.99 mbar; 95 %CI = [1.63-4.35]; p < 0.0001), along with a higher V<sub>te</sub> (RC = 42.42 ml; 95 %CI = [32.07-52.27]; p < 0.0001), and a lower V<sub>leak</sub> (RC = -55.03 %; 95 %CI = [-62.92-47.15]; p < 0.0001). In comparisons among the individual SGA, lower pCCSV-values were observed for Ambu®AuraGain™ versus I-GEL® (RC = -2.58 mbar; 95 %CI = [-4.04--1.13]; p = 0.0006), Ambu®AuraGain™ versus LTS-D® (RC = -1.73 mbar; 95 %CI = [-3.18--0.27]; p = 0.0204), and LTS-D® versus I-GEL® (RC = -0.86 mbar; 95 %CI = [-2.30-0.59]; p = 0.2434).</p><p><strong>Conclusion: </strong>SGA were associated with a lower likelihood of reaching the target range of pCCSV, lower V<sub>te</sub>, and higher V<sub>leak</sub>. Regardless the airway device, CCSV-failure is possible emphasizing the need for vigilant respiratory monitoring.</p><p><strong>Registration: </strong>URL: https://www.</p><p><strong>Clinicaltrials: </strong>gov. Unique identifier number: NCT06306898.</p>\",\"PeriodicalId\":21052,\"journal\":{\"name\":\"Resuscitation\",\"volume\":\" \",\"pages\":\"110795\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-09-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Resuscitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.resuscitation.2025.110795\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Resuscitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.resuscitation.2025.110795","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Efficacy of supraglottic airway devices in chest compression synchronized ventilation during continuous resuscitation: a prospective randomized cross-over cadaver study.
Background: This study aimed to evaluate the efficacy of Chest-Compression-Synchronized-Ventilation (CCSV) using supraglottic airway devices (SGA) compared to tracheal intubation (TI) for ventilation during continuous resuscitation.
Methods: In this cross-over study, the lungs of adult Thiel-embalmed cadavers were initially recruited using TI. Subsequently, various SGA (Laryngeal-Mask = Ambu®AuraGain™, Laryngeal-Tube = LTS-D®, i-gel-Laryngeal-Mask = I-GEL®) and TI were applied in randomized order during continuous chest compressions. CCSV was delivered with a CCSV-Pressure (pCCSV) = 40 mbar, PEEP = 3 mbar, respiratory-rate (RR) synchronized with the chest compression rate. The primary endpoint was achieving a pCCSV = 40 ± 3 mbar. Secondary endpoints included pCCSV, expiratory tidal (Vte) 1 ml/kgBW and leakage volumes (Vleak). Logistic regression models with random intercepts were used for the primary outcome, and linear mixed models were applied for secondary outcomes.
Results: Eleven cadavers were included. While two(18 %) were successfully ventilated with all airway types, three(27 %) could only be ventilated with an TI. Two cadavers(18 %) could not be sufficiently ventilated with any of the airway devices including TI. When comparing TI and SGA, for TI a greater chance of reaching the target corridor of pCCSV (Odds Ratio(OR) = 1.87; 95 %-Confidence-Interval(95 %CI) = [0.91-3.83]; P = 0.0864) and a higher pCCSV was observed (regression-coefficient(RC) = 2.99 mbar; 95 %CI = [1.63-4.35]; p < 0.0001), along with a higher Vte (RC = 42.42 ml; 95 %CI = [32.07-52.27]; p < 0.0001), and a lower Vleak (RC = -55.03 %; 95 %CI = [-62.92-47.15]; p < 0.0001). In comparisons among the individual SGA, lower pCCSV-values were observed for Ambu®AuraGain™ versus I-GEL® (RC = -2.58 mbar; 95 %CI = [-4.04--1.13]; p = 0.0006), Ambu®AuraGain™ versus LTS-D® (RC = -1.73 mbar; 95 %CI = [-3.18--0.27]; p = 0.0204), and LTS-D® versus I-GEL® (RC = -0.86 mbar; 95 %CI = [-2.30-0.59]; p = 0.2434).
Conclusion: SGA were associated with a lower likelihood of reaching the target range of pCCSV, lower Vte, and higher Vleak. Regardless the airway device, CCSV-failure is possible emphasizing the need for vigilant respiratory monitoring.
期刊介绍：
Resuscitation is a monthly international and interdisciplinary medical journal. The papers published deal with the aetiology, pathophysiology and prevention of cardiac arrest, resuscitation training, clinical resuscitation, and experimental resuscitation research, although papers relating to animal studies will be published only if they are of exceptional interest and related directly to clinical cardiopulmonary resuscitation. Papers relating to trauma are published occasionally but the majority of these concern traumatic cardiac arrest.
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