Abstract
BACKGROUND: New devices are now available to provide real-time feedback on ventilation for basic life support providers responding to out-of-hospital cardiac arrest (OHCA). This scoping review, conducted as part of the evidence review for the International Liaison Committee on Resuscitation, aimed to examine the extent of evidence examining ventilation feedback devices and to identify research gaps regarding these devices. METHODS: This scoping review was conducted using Arksey and O'Malley's framework and reported according to PRISMA-ScR guidelines. Medline, EMBASE and Cochrane were searched from database inception to March 13th, 2025. Studies examining real-time ventilation quality feedback in humans and manikins of any design were included. Ventilation feedback devices were defined as any device that can provide information on the delivery of each insufflation (including insufflation and/or exsufflation measured volume as well as rate) and to guide the ventilation through real-time feedback. RESULTS: We screened 794 titles, with 17 studies (including 4 conference abstracts) included: one randomised trial (RCT), one before-after prospective studies, two observational studies, one case series and 12 simulation studies. Only three simulation studies assessed a pediatric scenario. The RCT reported improved early outcomes (unadjusted return of spontaneous circulation and 30-hour survival) with real-time feedback, but no difference at hospital discharge. Two observational studies also found no change in patient outcomes, but noted improved ventilation rate and insufflation volumes. Most simulation studies showed improvements in ventilation parameters. CONCLUSION: Real-time feedback devices seem to improve ventilations, but we found insufficient evidence of their effect on clinical outcomes to merit a systematic review at this time. Rigorous evaluation of the clinical efficacy and effectiveness of these devices is needed.