Ventilation during resuscitation efforts for out-of-hospital primary cardiac arrest

Bentley J. Bobrow, Gordon A. Ewy

Research output: Contribution to journalReview articlepeer-review

21 Scopus citations


PURPOSE OF REVIEW: To discuss recent findings surrounding the role of ventilation during cardiopulmonary resuscitation for individuals with out-of-hospital primary cardiac arrest. RECENT FINDINGS: Active assisted ventilation during primary cardiac arrest may not always be beneficial and, in some circumstances, may lead to worse outcomes. By interrupting chest compressions and thereby decreasing vital organ perfusion, rescue breathing may be deleterious. In addition to the time required to administer breaths, the delay due to the insertion of advanced airways, even by well trained individuals, is often extensive. Furthermore, once intubation is completed, excessive hyperventilation occurs frequently, even by recently trained medical providers. Although most experts agree that excessive ventilation is harmful during out-of-hospital cardiac resuscitation, the optimal rate, tidal volume, timing, and technique of ventilation is still unknown. There is increasing evidence that, in patients with witnessed arrests and a shockable rhythm, the optimal form of ventilation is passive oxygen insufflation. SUMMARY: Assisted ventilation during the initial provision of cardiopulmonary resuscitation is less important than previously believed. It is hypothesized that, by training prehospital medical providers to utilize passive oxygen insufflation for individuals with primary cardiac arrest, critical organ perfusion will increase and, therefore, survival after out-of-hospital cardiac arrest will improve.

Original languageEnglish (US)
Pages (from-to)228-233
Number of pages6
JournalCurrent opinion in critical care
Issue number3
StatePublished - Jun 2009
Externally publishedYes


  • Cardiac arrest
  • Cardiocerebral resuscitation
  • Continuous chest compression CPR
  • Ventilation
  • Ventricular fibrillation

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine


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