This Bayesian meta-analysis included eight studies involving 6,847 adults with cardiac arrest, comparing mechanical ventilation during CPR with manual bag-valve ventilation alone. Mechanical ventilation was associated with more ROSC (pooled RR 1.20; 95% credible interval 1.04–1.42), with a 99% posterior probability of benefit. Posterior probabilities favoring mechanical ventilation were 92.3% for survival to admission, 93.6% for survival to discharge, and 92.2% for favorable neurological outcome. Despite these directional signals, evidence for improved survival and neurological outcomes remained imprecise and inconclusive.
Mechanical ventilation during CPR was associated with higher ROSC, but a survival or neurological benefit remains uncertain. These findings do not establish superiority for patient-centred outcomes.
Study limitation: Classification as mechanical ventilation required any use during CPR, so this group could also have received manual ventilation.
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