{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T22:59:11Z","timestamp":1769554751152,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Mechanical cardiopulmonary resuscitation (mCPR) devices offer consistent chest compressions during prolonged resuscitations and transport, but their impact on ventilation and patient outcomes remains unclear. This study aimed to compare gas exchange, metabolic parameters, and clinical outcomes in patients with ongoing manual versus mechanical CPR upon arrival at the emergency department (ED) after out-of-hospital cardiac arrest (OHCA). Methods: We conducted a retrospective analysis of 394 consecutive adult patients with non-traumatic OHCA admitted to a metropolitan cardiac arrest center between January 2019 and December 2024. Patients were categorized into three groups: Return of spontaneous circulation (ROSC) on arrival (n = 240), ongoing manual CPR (n = 107), and ongoing mechanical CPR (n = 47). Gas exchange and metabolic parameters were obtained from initial arterial blood gas (ABG) analysis and monitor readings. The primary outcome was survival to hospital discharge; secondary outcomes included 24 h survival and neurological status at discharge (CPC 1\u20132). Results: Survival to hospital discharge was significantly higher in the manual CPR group (8.4%) compared to 0% in the mechanical CPR group (p = 0.04). Both groups showed severe acidosis and hypercapnia upon ED arrival; however, PaCO2 levels were significantly higher in the mCPR group (83.0 \u00b1 25.5 mmHg vs. 72.3 \u00b1 21.6 mmHg, p = 0.01). ROC analysis identified lactate (AUC = 0.765) and pH (AUC = 0.743) as the strongest predictors of survival, while EtCO2 had limited prognostic value (AUC = 0.541). Conclusions: In patients with refractory out-of-hospital cardiac arrest admitted with ongoing cardiopulmonary resuscitation, mechanical CPR was associated with higher PaCO2 levels on emergency department arrival compared with manual CPR, while other gas exchange parameters did not differ significantly. Given the limited sample size and small number of survivors, these findings are exploratory and hypothesis-generating, underscoring the need for prospective studies on ventilation during continuous chest compressions.<\/jats:p>","DOI":"10.3390\/jcm15030933","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:21:40Z","timestamp":1769505700000},"page":"933","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Continuous Compressions, Incomplete Ventilation? A Retrospective Analysis of mCPR in Admitted ED Patients"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6820-3005","authenticated-orcid":false,"given":"Ingo","family":"Voigt","sequence":"first","affiliation":[{"name":"Department of Acute and Emergency Medicine, Elisabeth-Hospital Essen, 45138 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6077-8164","authenticated-orcid":false,"given":"Mehran","family":"Babady","sequence":"additional","affiliation":[{"name":"Department of Acute and Emergency Medicine, Elisabeth-Hospital Essen, 45138 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katharina","family":"Sch\u00fctte-N\u00fctgen","sequence":"additional","affiliation":[{"name":"Department of Acute and Emergency Medicine, Elisabeth-Hospital Essen, 45138 Essen, Germany"},{"name":"Faculty of Medicine, University of M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raimund","family":"Grondstein","sequence":"additional","affiliation":[{"name":"Department of Acute and Emergency Medicine, Elisabeth-Hospital Essen, 45138 Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Bruder","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Angiology, Elisabeth-Hospital Essen, 45138 Essen, Germany"},{"name":"Faculty of Medicine, Ruhr-University Bochum, 44801 Bochum, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1007\/s00134-021-06368-4","article-title":"European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: Post-resuscitation care","volume":"47","author":"Nolan","year":"2021","journal-title":"Intensive Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.resuscitation.2021.02.010","article-title":"European Resuscitation Council Guidelines 2021: Adult advanced life support","volume":"161","author":"Soar","year":"2021","journal-title":"Resuscitation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1016\/j.resuscitation.2021.02.011","article-title":"European Resuscitation Council Guidelines 2021: Cardiac arrest in special circumstances","volume":"161","author":"Lott","year":"2021","journal-title":"Resuscitation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S366","DOI":"10.1161\/CIR.0000000000000916","article-title":"Part 3: Adult Basic and Advanced Life Support: 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care","volume":"142","author":"Panchal","year":"2020","journal-title":"Circulation"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1186\/s13054-024-05037-4","article-title":"Mechanical versus manual cardiopulmonary resuscitation (CPR): An umbrella review of contemporary systematic reviews and more","volume":"28","author":"Naduvilekandy","year":"2024","journal-title":"Crit. 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