ArticleResuscitation plus2026
Pediatric versus adult self-inflating bags for cardiopulmonary resuscitation of adult patients with cardiac arrest - a non-randomized controlled trial.
Article in Resuscitation plus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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4 authors.
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Abstract
Background: Excessive ventilation during cardiopulmonary resuscitation (CPR) may compromise hemodynamics by elevating intrathoracic pressure and reducing venous return. Standard adult self-inflating bags often deliver tidal volumes exceeding American Heart Association (AHA) and European Resuscitation Council (ERC) guidelines (6-7 ml/kg of Predicted Body Weight (PBW)). We hypothesized that employing a pediatric self-inflating bag during extended CPR in intubated adult cardiac arrest patients would yield tidal volumes more in line with guideline recommendations. Method: This was a single blinded, non-randomized controlled study conducted from October 2022 to October 2023 at a tertiary academic Emergency Department (ED) after ethical committee approval (Trial registration: ISRCTN10909864). Asynchronous ventilation was delivered during CPR using an adult self-inflating bag (1600 mL) in patients who were endotracheally intubated. For patients meeting termination-of-resuscitation (TOR) criteria, extended CPR was delivered using a pediatric self-inflating bag (750 mL). Ventilatory metrics were recorded via a CITREX H3 Gas Flow Analyzer connected between the endotracheal tube and the bag. The primary objective was to compare the inspired (VTi) and expired (VTe) tidal volumes delivered by the two devices, while the secondary objective was to determine the VTi required to achieve visible chest rise. Results: Of 224 patients screened for eligibility, 132 (59%) were enrolled after excluding 2 (1.5%) patients who achieved return of spontaneous circulation (ROSC), 130 (98.5%) patients were included in the final analysis. The adult self-inflating bag delivered a median VTi of 8.7 mL/kg of PBW [IQR 7.5-10.3], significantly higher than the pediatric bag (6.4 mL/kg PBW [IQR 5.45-7.7] ( Conclusion: In intubated adults during CPR, pediatric self-inflating bags delivered case-average tidal volumes per predicted body weight closer to weight-based ventilation targets (ERC 2015 guidelines), with higher odds of achieving the target tidal volume range compared with standard adult bags. However, clinical outcomes were not evaluated.
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