Real-world adoption and use of a ventilation feedback device during out-of-hospital cardiac arrest: a population-based observational study from a French prehospital system.
Resuscitation Plus · 2026-08-25 · Observational study
Abstract
BACKGROUND: Ventilation quality during cardiopulmonary resuscitation remains highly variable despite clear guidelines. Ventilation feedback devices have shown substantial improvements in simulated settings, but real-world implementation data remain limited.We aimed to evaluate real-world adoption and use of a ventilation feedback device during out-of-hospital cardiac arrest (OHCA) management in a French prehospital system. METHODS: We conducted a retrospective, population-based observational study of adult OHCAs jointly managed by firefighters and Mobile Intensive Care Unit teams in the Doubs region. Cases from 2022 (pre-implementation) and 2024 (post-implementation) were analysed. The primary outcome was device utilisation. Secondary outcomes included return of spontaneous circulation, survival, and neurological status, reported descriptively and exploratorily. RESULTS: Among 756 patients, 190 (2022) and 166 (2024) met the inclusion criteria. Despite a protocol mandating its systematic use, the device was used in 48/166 (28.9%) cases.Baseline characteristics and resuscitation variables were comparable between groups. Exploratory analyses showed return of spontaneous circulation in 25.0% with device versus 16.1% without (unadjusted odds ratio (OR) = 1.74 confidence interval (CI) 95% [0.77; 3.93]), and survival at day 30 in 10.4% versus 4.2% (unadjusted OR = 2.63 [0.72; 9.53]). Favourable neurological outcome at day 30 was observed in 10.4% versus 3.4% (unadjusted OR = 3.28 [0.84; 12.8]). Given the observational design and limited sample size, these findings should be interpreted as hypothesis-generating. CONCLUSION: This study highlights a discrepancy between protocol and real-world use of a ventilation feedback device during out-of-hospital cardiac arrest. They underscore the need to better understand implementation factors to inform future studies evaluating clinical effectiveness. Future research should incorporate robust implementation strategies and standardised ventilation parameters.
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Tags
CPR feedback devices · Implementation · Mortality & survival · Fire service & police · Quality of life & function
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