CAvent-Ventilation During Advanced Cardiopulmonary Resuscitation in Out-of-hospital Cardiac Arrest- an Observational Study (CAvent)

The aim of this observational study is to investigate how ventilations is given during cardiopulmonary resuscitation (CPR) given by advanced life support providers (ALS). A portable device capable of detailed measurments of ventilation will be used when ventilating patients suffering cardiac arrest.

The main objective of the study is to describe the ventilatiosn given in terms of volume, frequency and pressure, both overall and during different CPR modes and when using different methods to handle the patients airway.

Study Overview

• Status: Completed
• Conditions: Out-of-Hospital Cardiac Arrest; Pulmonary Ventilation
• Intervention / Treatment: Device: Fluxmed GrH portable pneumotachograph

Detailed Description

The aim with this observational multicenter study is to measure and describe manual ventilation during cardiopulmonary resuscitation in the advance life support setting.

Primary endpoint is the ventilation quality measured as ventilation frequency, tidal volume, minute ventilation peak inspiratory pressure and exhaled CO2.

This will be studied in both asycnhronous ventilations, meaning ventilations that are given during ongoing chest compressions and syncrhonous ventilations, meaning ventilations given during a pause of the chest compressions, in a 30:2 repeatign pattern. Aditionally, airway modalities such as bag-valve-masks, Supraglottic airway devices and endotracheal tubes will be studied.

The inclusion of patients will be performed at five sites, The Uppsala emergency medical services, Uppsala, Sweden, Capio AB akutläkarbilar (rapid response cars), Stockholm Sweden, Falun County hospital, Falun, Sweden, EMS Amsterdam post West, Amsterdam, The Netherlands and Lifeliner 1 HEMS, Amsterdam, The Netherlands Eligible for inclusion are patients over 18 years old suffering cardiac arrest in the areas served by the including emergency medical systems and in-hospital emergency team.

The goal is to include at least 200 patients.

• Study Type: Observational
• Enrollment (Actual): 241

Contacts and Locations

Study Locations

• Netherlands
  • Amsterdam, Netherlands
    • Amsterdam UMC
  • Utrecht
    • Amersfoort, Utrecht, Netherlands
      • Regionale Ambulance Voorziening Utrecht, Netherlands
• Sweden
  • Falun, Sweden
    • Falun county hospital
  • Stockholm, Sweden
    • Capio AB Rapid Response Cars
  • Uppsala, Sweden, 75185
    • Uppsala University Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

Patients suffering sudden cardic arrest treated with CPR by ALS-providers in Uppsala, Amsterdam, Stockholm and Falun county hospital.

Description

Inclusion Criteria:

Out-of-hospital cardiac arrest (OHCA) treated with CPR performed by the EMS personnel

Exclusion Criteria:

• Patient age < 18 years
• Known pregnancy

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Patient recieving asycnhronous ventilations	Device: Fluxmed GrH portable pneumotachograph; Fluxmed GrH portable pneumotachograph is used to measure the given ventilation. It is placed on the chosen airway adjunct and passively measures ventilation parameters such as volumes, and flow.
Patient recieving synchronous ventilations	Device: Fluxmed GrH portable pneumotachograph; Fluxmed GrH portable pneumotachograph is used to measure the given ventilation. It is placed on the chosen airway adjunct and passively measures ventilation parameters such as volumes, and flow.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Ventilation frequency	Measured as ventilations per minute.	1 Day
Tidal volume	Measured as milliliters per ventilation.	1 Day
Minute Ventilation	Measured as litres per minute.	1 Day

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Variation of etCO2 in relation to different ratios of compression to ventilations	etCO2 measured as kilopascal for each exhalation during CPR with 30 compressions and 2 ventilations and during continous compressions and ventilations.	1 Day
Time of inspiration	Measured as seconds for each inspiration.	1 Day
Fraction of dead space ventilation	Dead space measured as milliliters for each ventilation compared to the tidal volume in milliters for that same ventilation.	1 Day
Peak inspiratory pressure during ventilation	Measured as cmH20 for each ventilation.	1 Day
Return of spontaneous circulation	If the patient, as stated by the ALS provider, has spontaneous circultation during the resuscitation attempt	1 Day

Collaborators and Investigators

• Sponsor: Uppsala University
• Collaborators: Regionale Ambulance Voorziening, Amersfoort, Utrecht, Netherlands; Dalarna County Hospital, Falun, Sweden; Amsterdam UMC; Capio AB Rapid Response Cars, Stockholm, Sweden
• Investigators: Principal Investigator: Sten Rubertsson, PhD, Uppsala University department of surgical sciences; Study Chair: David Smekal, PhD, Uppsala University department of surgical sciences; Study Chair: Johan Mällberg, BsSC, Uppsala University department of surgical sciences

Publications and helpful links

General Publications

• Perkins GD, Handley AJ, Koster RW, Castren M, Smyth MA, Olasveengen T, Monsieurs KG, Raffay V, Grasner JT, Wenzel V, Ristagno G, Soar J; Adult basic life support and automated external defibrillation section Collaborators. European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation. 2015 Oct;95:81-99. doi: 10.1016/j.resuscitation.2015.07.015. Epub 2015 Oct 15. No abstract available.
• Nizhenkovska IV, Pidchenko VT, Bychkova NG, Bisko NA, Rodnichenko AY, Kozyko NO. Influence of Ganoderma lucidum (Curt.: Fr.) P. Karst. on T-cell-mediated immunity in normal and immunosuppressed mice line CBA/Ca. Ceska Slov Farm. 2015 Sep;64(4):139-43.
• Hollenberg J, Svensson L, Rosenqvist M. Out-of-hospital cardiac arrest: 10 years of progress in research and treatment. J Intern Med. 2013 Jun;273(6):572-83. doi: 10.1111/joim.12064. Epub 2013 Apr 1.
• Grasner JT, Lefering R, Koster RW, Masterson S, Bottiger BW, Herlitz J, Wnent J, Tjelmeland IB, Ortiz FR, Maurer H, Baubin M, Mols P, Hadzibegovic I, Ioannides M, Skulec R, Wissenberg M, Salo A, Hubert H, Nikolaou NI, Loczi G, Svavarsdottir H, Semeraro F, Wright PJ, Clarens C, Pijls R, Cebula G, Correia VG, Cimpoesu D, Raffay V, Trenkler S, Markota A, Stromsoe A, Burkart R, Perkins GD, Bossaert LL; EuReCa ONE Collaborators. Corrigendum to "EuReCa ONE-27 Nations, ONE Europe, ONE Registry A prospective one month analysis of out-of-hospital cardiac arrest outcomes in 27 countries in Europe" [Resuscitation 105 (2016) 188-195]. Resuscitation. 2016 Dec;109:145-146. doi: 10.1016/j.resuscitation.2016.10.001. Epub 2016 Oct 15. No abstract available.
• Kern KB, Hilwig RW, Berg RA, Sanders AB, Ewy GA. Importance of continuous chest compressions during cardiopulmonary resuscitation: improved outcome during a simulated single lay-rescuer scenario. Circulation. 2002 Feb 5;105(5):645-9. doi: 10.1161/hc0502.102963.
• Pollack RA, Brown SP, Rea T, Aufderheide T, Barbic D, Buick JE, Christenson J, Idris AH, Jasti J, Kampp M, Kudenchuk P, May S, Muhr M, Nichol G, Ornato JP, Sopko G, Vaillancourt C, Morrison L, Weisfeldt M; ROC Investigators. Impact of Bystander Automated External Defibrillator Use on Survival and Functional Outcomes in Shockable Observed Public Cardiac Arrests. Circulation. 2018 May 15;137(20):2104-2113. doi: 10.1161/CIRCULATIONAHA.117.030700. Epub 2018 Feb 26.
• Nolan JP, Soar J, Zideman DA, Biarent D, Bossaert LL, Deakin C, Koster RW, Wyllie J, Bottiger B; ERC Guidelines Writing Group. European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive summary. Resuscitation. 2010 Oct;81(10):1219-76. doi: 10.1016/j.resuscitation.2010.08.021. No abstract available.
• Perkins GD, Olasveengen TM, Maconochie I, Soar J, Wyllie J, Greif R, Lockey A, Semeraro F, Van de Voorde P, Lott C, Monsieurs KG, Nolan JP; European Resuscitation Council. European Resuscitation Council Guidelines for Resuscitation: 2017 update. Resuscitation. 2018 Feb;123:43-50. doi: 10.1016/j.resuscitation.2017.12.007. Epub 2017 Dec 9. No abstract available.
• Becker TK, Berning AW, Prabhu A, Callaway CW, Guyette FX, Martin-Gill C. An assessment of ventilation and perfusion markers in out-of-hospital cardiac arrest patients receiving mechanical CPR with endotracheal or supraglottic airways. Resuscitation. 2018 Jan;122:61-64. doi: 10.1016/j.resuscitation.2017.11.054. Epub 2017 Nov 23.
• Axelsson C, Karlsson T, Axelsson AB, Herlitz J. Mechanical active compression-decompression cardiopulmonary resuscitation (ACD-CPR) versus manual CPR according to pressure of end tidal carbon dioxide (P(ET)CO2) during CPR in out-of-hospital cardiac arrest (OHCA). Resuscitation. 2009 Oct;80(10):1099-103. doi: 10.1016/j.resuscitation.2009.08.006. Epub 2009 Aug 28.

Helpful Links

• Hjärt-lungräddningsregistret årsrapport 2017. Stockholm: HLR rådet

Study record dates

Study Major Dates

• Study Start (Actual): May 1, 2019
• Primary Completion (Actual): August 31, 2025
• Study Completion (Actual): December 1, 2025

Study Registration Dates

• First Submitted: April 4, 2019
• First Submitted That Met QC Criteria: January 17, 2020
• First Posted (Actual): January 23, 2020

Study Record Updates

• Last Update Posted (Actual): April 7, 2026
• Last Update Submitted That Met QC Criteria: March 31, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: Cardiopulmonary Resuscitation; Respiration, Artificial; Out-of-Hospital Cardiac Arrest
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Pathologic Processes; Heart Diseases; Respiratory Tract Diseases; Respiration Disorders; Heart Arrest; Pathological Conditions, Signs and Symptoms; Respiratory Aspiration; Out-of-Hospital Cardiac Arrest
• Other Study ID Numbers: VENT001

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No