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Title: | Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest | Authors: | Kajino, K Iwami, T Kitamura, T Daya, M Ong, M.E.H Nishiuchi, T Hayashi, Y Sakai, T Shimazu, T Hiraide, A Kishi, M Yamayoshi, S |
Keywords: | adrenalin aged article comparative effectiveness controlled study emergency care emergency health service emergency medical services education endotracheal intubation female heart ventricle fibrillation hospital admission human Japan major clinical study male neurologic examination observational study out of hospital cardiac arrest outcome assessment post treatment survival practice guideline priority journal prospective study respiratory tract intubation resuscitation return of spontaneous circulation supraglottic airway clinical protocol comparative study emergency health service laryngeal mask methodology middle aged mortality out of hospital cardiac arrest survival treatment outcome Aged Aged, 80 and over Clinical Protocols Emergency Medical Services Female Humans Intubation, Intratracheal Japan Laryngeal Masks Male Middle Aged Out-of-Hospital Cardiac Arrest Prospective Studies Survival Analysis Treatment Outcome |
Issue Date: | 2011 | Citation: | Kajino, K, Iwami, T, Kitamura, T, Daya, M, Ong, M.E.H, Nishiuchi, T, Hayashi, Y, Sakai, T, Shimazu, T, Hiraide, A, Kishi, M, Yamayoshi, S (2011). Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest. Critical Care 15 (5) : R236. ScholarBank@NUS Repository. https://doi.org/10.1186/cc10483 | Rights: | Attribution 4.0 International | Abstract: | Introduction: Both supraglottic airway devices (SGA) and endotracheal intubation (ETI) have been used by emergency life-saving technicians (ELST) in Japan to treat out-of-hospital cardiac arrests (OHCAs). Despite traditional emphasis on airway management during cardiac arrest, its impact on survival from OHCA and time dependent effectiveness remains unclear.Methods: All adults with witnessed, non-traumatic OHCA, from 1 January 2005 to 31 December 2008, treated by the emergency medical services (EMS) with an advanced airway in Osaka, Japan were studied in a prospective Utstein-style population cohort database. The primary outcome measure was one-month survival with neurologically favorable outcome. The association between type of advanced airway (ETI/SGA), timing of device placement and neurological outcome was assessed by multiple logistic regression.Results: Of 7,517 witnessed non-traumatic OHCAs, 5,377 cases were treated with advanced airways. Of these, 1,679 were ETI while 3,698 were SGA. Favorable neurological outcome was similar between ETI and SGA (3.6% versus 3.6%, P = 0.95). The time interval from collapse to ETI placement was significantly longer than for SGA (17.2 minutes versus 15.8 minutes, P < 0.001). From multivariate analysis, early placement of an advanced airway was significantly associated with better neurological outcome (Adjusted Odds Ratio (AOR) for one minute delay, 0.91, 95% confidence interval (CI) 0.88 to 0.95). ETI was not a significant predictor (AOR 0.71, 95% CI 0.39 to 1.30) but the presence of an ETI certified ELST (AOR, 1.86, 95% CI 1.04 to 3.34) was a significant predictor for favorable neurological outcome.Conclusions: There was no difference in neurologically favorable outcome from witnessed OHCA for ETI versus SGA. Early airway management with advanced airway regardless of type and rhythm was associated with improved outcomes. © 2011 Kajino et al.; licensee BioMed Central Ltd. | Source Title: | Critical Care | URI: | https://scholarbank.nus.edu.sg/handle/10635/180853 | ISSN: | 1364-8535 | DOI: | 10.1186/cc10483 | Rights: | Attribution 4.0 International |
Appears in Collections: | Staff Publications Elements |
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