Neurological outcome of out-of-hospital cardiac arrest patients ventilated with continuous flow insufflation of oxygen: a multicenter observational study

PURPOSE: A continuous flow insufflation of oxygen (CFIO) device through a face mask has been developed to minimize chest compression interruptions and optimize ventilation during cardiopulmonary resuscitation (CPR). The objective of this study was to assess the association between CFIO versus bag-valve-mask (BVM) ventilation with favorable neurological outcome at day 30 in adults with out-of-hospital cardiac arrest (OHCA). METHODS: A multicenter observational cohort study was performed. Adult patients from the Northern French Alps Emergency Network cardiac arrest registry who experienced OHCA in three different Emergency Medical Systems between 2017 and 2021 were included. The Emergency Medical Systems employed different ventilation practices, thus enabling the establishment of two distinct groups for comparison: the exposure group that underwent CFIO through a face mask (using a Boussignac valve device), and a control group that underwent ventilation with a BVM. The primary outcome was the 30-day neurological status according to the Cerebral Performance Category (CPC) scale (favorable: CPC 1 or 2). RESULTS: Of the 2237 included patients, 967 (43%) received CFIO and 1270 (57%) were ventilated with a BVM. In multivariable analysis, CFIO was associated with a significantly lower odds ratio (OR) of favorable 30-day neurological outcome in comparison to the control (BVM) group (adjusted OR: 0.61 [95%CI: 0.41-0.9]; p = 0.01). CONCLUSION: The use of CFIO during OHCA was associated with significantly lower odds of favorable neurological outcome at day 30 compared to BVM.