Chest Compression Synchronized Mechanical Ventilation Modes for Cardiac Arrest; A Scoping Review

Area of Science:

• Cardiopulmonary resuscitation
• Ventilation strategies
• Hemodynamic optimization

Background:

• Chest Compression Synchronized Ventilation (CCSV) is a novel approach during cardiopulmonary resuscitation (CPR).
• Its clinical value, safety, and implementation barriers are not well-defined.
• Existing evidence on CCSV during cardiac arrest needs systematic synthesis.

Purpose of the Study:

• To systematically review and synthesize evidence on CCSV during cardiac arrest in animal and human studies.
• To evaluate the physiological effects and safety of CCSV.
• To identify gaps in current research.

Main Methods:

• A comprehensive scoping review was conducted.
• Searched five major databases (Medline, Embase, CENTRAL, Scopus, Web of Science) up to May 2025.
• Included studies on CCSV or related ventilation strategies during cardiac arrest, irrespective of design, language, or date.

Main Results:

• Thirty-two studies (1980-2025) were included, predominantly animal models (n=19) with limited human data (n=10).
• CCSV demonstrated improved arterial oxygenation, CO2 clearance, hemodynamics, and cerebral oxygenation versus conventional ventilation.
• Adverse events like pneumothorax and lung injury were reported inconsistently.

Conclusions:

• CCSV shows promising physiological benefits in experimental CPR settings.
• Human data is scarce, highlighting the need for larger prospective human trials.
• Further research is crucial to establish clinical effectiveness, guide implementation, and assess risks compared to standard CPR ventilation.