Kyung Kang1, Taeyun Kim2, Young Sun Ro3, Yu Jin Kim4, Kyung Jun Song5, Sang Do Shin6. 1. Dept. of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro Bundang-gu, Seongnam 463-707, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: Kangkyoung83@hanmail.net. 2. Dept. of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro Bundang-gu, Seongnam 463-707, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: emkity@gmail.com. 3. Dept. of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: blueelf7@gmail.com. 4. Dept. of Emergency Medicine, Seoul National University Bundang Hospital, 166 Gumi-ro Bundang-gu, Seongnam 463-707, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: myda02@gmail.com. 5. Dept. of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: skciva@gmail.com. 6. Dept. of Emergency Medicine, Seoul National University Hospital, 101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea; Biomedical Research Institute, Seoul National University Hospital,101 Daehak-ro Jongno-gu, Seoul 110-744, Republic of Korea. Electronic address: shinsangdo@medimail.co.kr.
Abstract
PURPOSE: Optimal out-of-hospital cardiac arrest (OHCA) airway management strategies are still controversial. Recent studies reported survival was higher among patients who received bag-valve-mask (BVM) than those receiving endotracheal intubation (ETI) or supraglottic airway (SGA). The aim of this study was to compare neurologically favorable survival outcomes among adult nontraumatic OHCA patients by prehospital airway. METHODS: We used the Korean nationwide OHCA cohort database from 2010 to 2013. The inclusion criteria were all OHCA adults with presumed cardiac etiology, resuscitated by level-1 emergency medical technician. Patients were excluded if their information about the method of prehospital airway or clinical outcomes at hospital discharge could not be captured. The primary outcome was neurologically favorable survival to discharge. We compared the outcomes among 3 groups (ETI, SGA, or BVM) by prehospital airway using multivariable logistic regression with interaction model. RESULTS: Of 98896 patients with OHCA, 32513 were included in analysis. Patients receiving BVM were 29684 and 2829 underwent advanced airway management including 1634 with SGA and 1195 with ETI. The odds of neurologically favorable survival to discharge was significantly higher in the ETI group compared to the BVM group (adjusted OR, 1.405; 95% CI, 1.1001-1.971). In the interaction model by witnessed status, the effect of ETI on good clinical outcomes was shown only in the patients whose arrest was unwitnessed. CONCLUSION: In this Korean nationwide, population-based OHCA cohort, neurologically favorable survival to hospital discharge rates was significantly higher among patients who received ETI than those receiving BVM or SGA.
PURPOSE: Optimal out-of-hospital cardiac arrest (OHCA) airway management strategies are still controversial. Recent studies reported survival was higher among patients who received bag-valve-mask (BVM) than those receiving endotracheal intubation (ETI) or supraglottic airway (SGA). The aim of this study was to compare neurologically favorable survival outcomes among adult nontraumatic OHCA patients by prehospital airway. METHODS: We used the Korean nationwide OHCA cohort database from 2010 to 2013. The inclusion criteria were all OHCA adults with presumed cardiac etiology, resuscitated by level-1 emergency medical technician. Patients were excluded if their information about the method of prehospital airway or clinical outcomes at hospital discharge could not be captured. The primary outcome was neurologically favorable survival to discharge. We compared the outcomes among 3 groups (ETI, SGA, or BVM) by prehospital airway using multivariable logistic regression with interaction model. RESULTS: Of 98896 patients with OHCA, 32513 were included in analysis. Patients receiving BVM were 29684 and 2829 underwent advanced airway management including 1634 with SGA and 1195 with ETI. The odds of neurologically favorable survival to discharge was significantly higher in the ETI group compared to the BVM group (adjusted OR, 1.405; 95% CI, 1.1001-1.971). In the interaction model by witnessed status, the effect of ETI on good clinical outcomes was shown only in the patients whose arrest was unwitnessed. CONCLUSION: In this Korean nationwide, population-based OHCA cohort, neurologically favorable survival to hospital discharge rates was significantly higher among patients who received ETI than those receiving BVM or SGA.
Authors: M Christ; K I von Auenmüller; T von den Benken; S Fessaras; W Dierschke; H-J Trappe Journal: Med Klin Intensivmed Notfmed Date: 2018-10-23 Impact factor: 0.840
Authors: Lars W Andersen; Asger Granfeldt; Clifton W Callaway; Steven M Bradley; Jasmeet Soar; Jerry P Nolan; Tobias Kurth; Michael W Donnino Journal: JAMA Date: 2017-02-07 Impact factor: 56.272
Authors: Yonghoon Jang; Tae Han Kim; Sun Young Lee; Young Sun Ro; Ki Jeong Hong; Kyoung Jun Song; Sang Do Shin Journal: Clin Exp Emerg Med Date: 2022-06-30