Comparing Positive End-Expiratory Pressure PEEP and Zero End-Expiratory Pressure ZEEP During Mechanical Ventilation in Adults with Out-of-Hospital Cardiac Arrest

What this Trial Is About

Researchers are investigating the effects of two different ventilation strategies during resuscitation in adult patients who experience out-of-hospital cardiac arrest OHCA. The study aims to compare positive-end-expiratory-pressure PEEP set at 5 mbar to zero-end-expiratory-pressure ZEEP to see which approach better supports the return of spontaneous circulation ROSC. This is a prospective, multicenter, cluster-randomized controlled trial involving emergency medical services in multiple regions. Patients aged 18 and older who have OHCA and require mechanical ventilation through an airway device will be enrolled. The study regions are randomized into two groups one will use PEEP at 5 mbar during ventilation, while the other will use ZEEP at 0 mbar. These ventilation settings are applied during emergency resuscitation before hospital admission. Participants will be monitored for the return of spontaneous circulation during or after resuscitation, which is the primary outcome. Secondary outcomes include rates of re-arrest, death during pre-hospital care, hospital admission with or without spontaneous circulation, and measurements of peripheral oxygen saturation and end tidal CO2 upon hospital arrival. The study will carefully track these outcomes to evaluate the impact of the ventilation strategies on patient survival and condition.

PEEP vs. ZEEP in Out-of-Hospital-Cardiac-Arrest