Abstract / Summary
Background: This study evaluated the effects of the new supraglottic airway device known as laryngeal tube evo on target parameters of ventilation therapy during mechanical chest compressions in intra-arrest ventilation with bag-valve-device ventilation vs. volume-controlled ventilation.
Methods: Thiel-embalmed human body donors were included in a standardized resuscitation scenario. Ventilation was performed in a randomized order using the laryngeal tube evo for bag-valve-device ventilation and volume-controlled ventilation during mechanical cardiopulmonary resuscitation. Expiratory (Vte) and expiratory tidal volumes per kg body weight (Vte/kgBW); delta tidal volume (difference between ideal and expiratory tidal volume; ΔVt); leakage volume (Vleak); peak (Ppeak); mean (Pmean) and plateau (Pplat) pressures and respiratory rates were recorded. The primary efficacy endpoint was Vte.
Results: Five body donors were included. Although one donor (20%) was successfully ventilated with all ventilation modes, three could only be ventilated with one of the modes (bag-valve-device ventilation = 20%; volume-controlled ventilation = 40%). One donor (20%) could not be sufficiently ventilated with any of the modes. Mean Vte was 91.73 ± 66.3 ml with bag-valve-device ventilation versus 142.93 ± 115.05 ml with volume-controlled ventilation. The comparison of both ventilation modes revealed higher Vte (50.27 ml; 95% confidence interval (CI): 7.56 to 92.97; p = 0.02), Vte/kgBW (0.8 ml; 95% CI: 0.05 to 1.56; p = 0.04), Pmean (5.23 mbar; 95% CI: 4 to 6.47; p < 0.0001) and Pplat (10.36 mbar; 95% CI: 8.08 to 12.64; p < 0.0001), but lower ∆Vt (- 50.3 ml; 95% CI: - 93 to - 7.59; p = 0.02) and respiratory rates (- 10.83/min; 95% CI: - 17.29 to - 4.36; p = 0.001) for volume-controlled ventilation.
Conclusions: Comparing volume-controlled ventilation with bag-valve-device ventilation for asynchronous ventilation during mechanical cardiopulmonary resuscitation using the laryngeal tube evo, volume-controlled ventilation resulted in higher Vte and Vte/kgBW, but lower ∆Vt and respiratory rates. Future studies should evaluate laryngeal tube evo in prehospital use during mechanical cardiopulmonary resuscitation. When doubts regarding its effectiveness are present, synchronous ventilation (30:2) should be performed.
Trial registration: German Clinical Trials Register; unique identifier: DRKS00037836. Registered on September 09, 2025 [1].