{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T12:14:08Z","timestamp":1789992848245,"version":"4.0.1"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T00:00:00Z","timestamp":1789948800000},"content-version":"am","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Airway opening index (AOI) is a metric recently described in adults to infer airway patency during cardiopulmonary resuscitation (CPR). The underlying premise is that higher AOI values suggest more patent airways, which leads to improved ventilation\/ outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>1) To quantitatively describe AOI during pediatric CPR and 2) to evaluate the association of AOI with outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prospective multicenter observational cohort study of children (\u226418 years) with invasive airways and capnography data. AOI was calculated as the average of ((delta CO2)\/max CO2) associated with each chest compression during a ventilation (range: 0 [closed] to 1 [open]). Cubic splines\/ receiver operating characteristic curves identified an AOI cutpoint for evaluation in modified Poisson regression models. A sensitivity analysis excluded extracorporeal CPR patients (E-CPR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>The primary outcome was survival to hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Results<\/jats:title>\n                    <jats:p>Among 99 events (median age: 0.34 [0.04, 3.26] yrs), median AOI was 0.38 [0.25, 0.53]. Event-level average AOI \u22650.35 was associated with improved survival to hospital discharge (aRR 1.53 [CI95 1.03, 2.28], p\u2009=\u20090.04) and favorable neurological outcome (aRR 1.56 [CI95 1.01, 2.41], p\u2009=\u20090.04) compared to AOI &amp;lt;0.35. Findings were robust when excluding E-CPR patients. After return of circulation, events with AOI \u22650.35 had lower peak arterial lactates (6.0 [2.8, 11.0] vs. 11.5 [6.4, 19.0] mmol\/L, p\u2009=\u20090.006), despite similar CPR durations (\u22650.35: 9 [3, 36] vs. &amp;lt;0.35: 8.5 [3, 21] min, p\u2009=\u20090.64).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this multicenter study, an AOI \u22650.35 was associated with improved survival outcomes. Events with AOI \u22650.35 had evidence of improved post-arrest physiology.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ajrccm\/aamag476","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:23:05Z","timestamp":1789755785000},"source":"Crossref","is-referenced-by-count":0,"title":["Alveolar Ventilation Efficiency Assessed via Capnography is Associated with Improved Outcomes in Pediatric Cardiac Arrest"],"prefix":"10.1093","author":[{"given":"Robert M","family":"Sutton","sequence":"first","affiliation":[{"name":"University of Pennsylvania Department of Anesthesiology and Critical Care Medicine, The Children\u2019s Hospital of Philadelphia, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dieter","family":"Bender","sequence":"additional","affiliation":[{"name":"Villanova University Villanova Center for Analytics of Dynamic Systems, , Villanova, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinod S","family":"Thakur","sequence":"additional","affiliation":[{"name":"Villanova University Villanova Center for Analytics of Dynamic Systems, , Villanova, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron W","family":"Reeder","sequence":"additional","affiliation":[{"name":"University of Utah Department of Pediatrics, , Salt Lake City, UT,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica S","family":"Alvey","sequence":"additional","affiliation":[{"name":"University of Utah Utah Data Coordinating Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Graham","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Department of Anesthesiology and Critical Care Medicine, The Children\u2019s Hospital of Philadelphia, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J","family":"O\u2019Halloran","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Department of Anesthesiology and Critical Care Medicine, The Children\u2019s Hospital of Philadelphia, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay N","family":"Shepard","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Department of Anesthesiology and Critical Care Medicine, The Children\u2019s Hospital of Philadelphia, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinay M","family":"Nadkarni","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Department of Anesthesiology and Critical Care Medicine, The Children\u2019s Hospital of Philadelphia, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"Berg","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Department of Anesthesiology and Critical Care Medicine, The Children\u2019s Hospital of Philadelphia, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Nataraj","sequence":"additional","affiliation":[{"name":"Villanova University Villanova Center for Analytics of Dynamic Systems, , Villanova, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan W","family":"Morgan","sequence":"additional","affiliation":[{"name":"University of Pennsylvania Department of Anesthesiology and Critical Care Medicine, The Children\u2019s Hospital of Philadelphia, , Philadelphia, PA,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,19]]},"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/advance-article-pdf\/doi\/10.1093\/ajrccm\/aamag476\/71252020\/aamag476.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/advance-article-pdf\/doi\/10.1093\/ajrccm\/aamag476\/71252020\/aamag476.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:45:59Z","timestamp":1789991159000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/advance-article\/doi\/10.1093\/ajrccm\/aamag476\/8820483"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,19]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ajrccm\/aamag476","relation":{},"ISSN":["1535-4970"],"issn-type":[{"value":"1535-4970","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,19]]},"article-number":"aamag476"}}