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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
comparative effectiveness
controlled study
emergency care
emergency health service
emergency medical services education
endotracheal intubation
heart ventricle fibrillation
hospital admission
major clinical study
neurologic examination
observational study
out of hospital cardiac arrest
outcome assessment
post treatment survival
practice guideline
priority journal
prospective study
respiratory tract intubation
return of spontaneous circulation
supraglottic airway
clinical protocol
comparative study
emergency health service
laryngeal mask
middle aged
out of hospital cardiac arrest
treatment outcome
Aged, 80 and over
Clinical Protocols
Emergency Medical Services
Intubation, Intratracheal
Laryngeal Masks
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.
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
ISSN: 1364-8535
DOI: 10.1186/cc10483
Rights: Attribution 4.0 International
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