Evaluation of ventilatory parameters reporting in large animal models of cardiac arrest: a scoping review

TL;DR

This study reviews how ventilatory parameters are reported in large animal models of cardiac arrest and finds significant inconsistencies and omissions.

Contribution

The study provides a comprehensive analysis of ventilatory parameter reporting in CPR research using large animal models.

Findings

Most studies used porcine models and ventricular fibrillation for inducing cardiac arrest.

Reporting of ventilatory settings like positive end-expiratory pressure and inspiratory to expiratory ratio was inconsistent.

Only a minority of studies reported measured ventilatory parameters like EtCO2 and arterial blood gases.

Abstract

Ventilation is a critical determinant of cardiopulmonary resuscitation efficiency. Our goal was to evaluate how ventilatory parameters are reported during cardiopulmonary resuscitation in large animal models of cardiac arrest.

A scoping review was conducted following the PRISMA-ScR guidelines, including studies referenced in Pubmed over the last decade (January 1st, 2015 to July 30th, 2025). The review followed the PCC approach: (P) population: large animal models of cardiac arrest; (C) concept: ventilatory settings and parameters during CPR; (C) context: studies aiming at describing or evaluating mechanical or manual ventilation during CPR in experimental conditions. The reporting of the animal characteristics, ventilatory settings and monitored parameters were extracted and analyzed descriptively.

We identified 111 relevant publications. Most of them used porcine models (79 %), with ventricular fibrillation being the most common method of cardiac arrest induction (59 %). Mechanical ventilation was predominant (75 %), with volume and pressure-controlled modes nearly equally represented. The reporting of critical ventilatory settings was inconsistent, with a percentage of appropriate reporting as follows: respiratory rate (88 %), fraction of inspired oxygen (83 %), positive end-expiratory pressure (49 %), tidal volume (83 %, among studies with volume-controlled ventilation), peak inspiratory pressure (92 %, among studies with pressure-controlled ventilation) and inspiratory to expiratory ratio (17 %, among all studies with mechanical ventilation). Reporting of measured ventilatory parameters during CPR was also limited with, e.g., EtCO2 reported in 41 % of the studies and arterial blood gases sampled and reported in 50 % of the studies.

This scoping review evidenced substantial variability and frequent omissions in the reporting of ventilatory settings and monitoring in large animal CPR studies. Updated recommendations could be useful to provide specific guidelines of reporting in the field.

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