It is imperative to monitor the quality of ventilation in cardiac arrest studies.

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In recent discussions surrounding the improvement of clinical outcomes in cardiac arrest cases, a significant oversight has been identified in the methodology of many clinical trials. A correspondence published in Resuscitation by Johannes Wittig et al (1), highlights indeed the substantial biases of studies conducted on ventilation as they fail to measure the quality of manual ventilation.  This flaw in research methodology not only compromises the validity of these studies but also hampers the advancement of resuscitation practices.

The essence of this argument hinges on the realization that the quality of ventilation during cardiac arrest – particularly manual ventilation – is a pivotal factor in patient outcomes. Despite this, the absence of systematic monitoring of ventilation quality in clinical trials has been overlooked for too long. This oversight is particularly concerning given the availability of Ventilation Feedback Devices (VFD) that can provide real-time, objective data on ventilation quality. 
The utilization of these Ventilation Feedback Devices (VFD) in clinical studies is not just a recommendation; it is a necessity. 

They ensure that the ventilation provided during cardiac arrest is within optimal parameters, thereby eliminating a major source of bias in studies. Without incorporating these devices, any clinical trial in the domain of cardiac arrest risks yielding results that are not only inaccurate but potentially misleading To further advance the field of resuscitation, it is imperative that future studies integrate the measurement of ventilation quality, especially during manual intra-arrest ventilation. This integration will not only enhance the reliability of research findings but also propel the development of more effective resuscitation techniques. 

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Ventilation Feedback Devices (VFD) hold the potential to illuminate the “black box” of intra-arrest ventilation, offering real-time insights into ventilation efficacy and facilitating prompt adjustments to optimize patient outcomes. In essence, the path to improving survival rates and outcomes for cardiac arrest patients lies in embracing and systematically implementing the use of ventilation feedback devices in clinical research and practice.

(1) Johannes Wittig, Kristian Krogh, Simon Orlob, Bo Løfgren, Kasper G. Lauridsen.

The black box of unmeasured intra-arrest ventilation

Resuscitation 2023, 110015

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