Dong Hyun Lee1, Myongja Han1, Ji Young An1, Ji Young Jung1, Younsuck Koh1, Chae-Man Lim1, Jin Won Huh1, Sang-Bum Hong2. 1. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea. 2. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Republic of Korea. Electronic address: sbhong@amc.seoul.kr.
Abstract
AIM: Tracheal intubation during cardiopulmonary resuscitation (CPR) is a high-risk procedure. Here, we investigated the efficacy of video laryngoscopy for tracheal intubation during CPR. METHODS: Data regarding tracheal intubation during CPR from in-hospital cardiac arrests occurring between January 2011 and December 2013 (n=229) were prospectively collected and retrospectively analyzed. RESULTS: The initial laryngoscopy method was video laryngoscopy in 121 patients (52.8%) and direct laryngoscopy in 108 patients (47.2%). The rate of successful intubation at the first attempt was higher with video laryngoscopy (71.9%; 87/121) than with direct laryngoscopy (52.8%; 57/108; p=0.003). The rate of success at the first attempt was higher for experienced (73.0%; 84/115) than inexperienced operators, including residents (52.6%; 60/114; p=0.001). Mortality at day 28 after CPR was not significantly different between patients with successful tracheal intubation at the first attempt and without (68.1% [98/144] vs. 67.1% [57/85]; p=0.876). In multivariate logistic regression analysis, a predicted difficult airway (odds ratio [95% confidence interval]=0.22 [0.10-0.49]; p<0.001), intubation by an experienced operator (2.63 [1.42-4.87]; p=0.002), and use of video laryngoscopy rather than direct laryngoscopy (2.42 [1.30-4.45]; p=0.005) were independently associated with a successful tracheal intubation at the first attempt. CONCLUSION: Use of video laryngoscopy during CPR from in-hospital cardiac arrest is independently associated with successful tracheal intubation at the first attempt.
AIM: Tracheal intubation during cardiopulmonary resuscitation (CPR) is a high-risk procedure. Here, we investigated the efficacy of video laryngoscopy for tracheal intubation during CPR. METHODS: Data regarding tracheal intubation during CPR from in-hospital cardiac arrests occurring between January 2011 and December 2013 (n=229) were prospectively collected and retrospectively analyzed. RESULTS: The initial laryngoscopy method was video laryngoscopy in 121 patients (52.8%) and direct laryngoscopy in 108 patients (47.2%). The rate of successful intubation at the first attempt was higher with video laryngoscopy (71.9%; 87/121) than with direct laryngoscopy (52.8%; 57/108; p=0.003). The rate of success at the first attempt was higher for experienced (73.0%; 84/115) than inexperienced operators, including residents (52.6%; 60/114; p=0.001). Mortality at day 28 after CPR was not significantly different between patients with successful tracheal intubation at the first attempt and without (68.1% [98/144] vs. 67.1% [57/85]; p=0.876). In multivariate logistic regression analysis, a predicted difficult airway (odds ratio [95% confidence interval]=0.22 [0.10-0.49]; p<0.001), intubation by an experienced operator (2.63 [1.42-4.87]; p=0.002), and use of video laryngoscopy rather than direct laryngoscopy (2.42 [1.30-4.45]; p=0.005) were independently associated with a successful tracheal intubation at the first attempt. CONCLUSION: Use of video laryngoscopy during CPR from in-hospital cardiac arrest is independently associated with successful tracheal intubation at the first attempt.
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