Wen-Chu Chiang1, Ming-Ju Hsieh2, Hsin-Lan Chu2, Albert Y Chen3, Shin-Yi Wen3, Wen-Shuo Yang4, Yu-Chun Chien5, Yao-Cheng Wang4, Bin-Chou Lee6, Huei-Chih Wang2, Edward Pei-Chuan Huang2, Chih-Wei Yang7, Jen-Tang Sun8, Kah-Meng Chong2, Hao-Yang Lin2, Shu-Hsien Hsu9, Shey-Ying Chen2, Matthew Huei-Ming Ma10. 1. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan. Electronic address: drchiang.tw@gmail.com. 2. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan. 3. Civil Engineering, National Taiwan University, Taipei, Taiwan. 4. Emergency Medical Services (Ambulance) Division, Taipei City Fire Department, Taipei, Taiwan. 5. Emergency Medical Services (Ambulance) Division, Taipei City Fire Department, Taipei, Taiwan; School of Public Health, Taipei Medical University, Taipei, Taiwan. 6. Taipei City Hospital, Chung-Shaw Branch, Taipei, Taiwan. 7. Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan. 8. Department of Emergency Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 9. Department of Emergency Medicine, National Taiwan University Hospital, Hsin-Chu Branch, Hsin-Chu City, Taiwan. 10. Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Emergency Medicine, National Taiwan University Hospital, Yun-Lin Branch, Yun-Lin County, Taiwan. Electronic address: mattma.tw@gmail.com.
Abstract
STUDY OBJECTIVE: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest survival in Taipei. METHODS: We analyzed 6 years of Utstein-based registry data from nontrauma adult patients with out-of-hospital cardiac arrest who underwent out-of-hospital airway management including intubation, laryngeal mask airway, or bag-valve-mask ventilation. The primary analysis was intubation success on patient outcomes. The primary outcome was survival to discharge and the secondary outcomes included sustained return of spontaneous circulation and favorable neurologic survival. Sensitivity analysis was performed with intubation attempts rather than intubation success. Subgroup analysis of advanced life support-serviced districts was also performed. RESULTS: A total of 10,853 cases from 2008 to 2013 were analyzed. Among out-of-hospital cardiac arrest patients receiving airway management, successful intubation, laryngeal mask airway, and bag-valve-mask ventilation was reported in 1,541, 3,099, and 6,213 cases, respectively. Compared with bag-valve-mask device use, successful out-of-hospital intubation was associated with improved chances of sustained return of spontaneous circulation (adjusted odds ratio [aOR] 1.91; 95% confidence interval [CI] 1.66 to 2.19), survival to discharge (aOR 1.98; 95% CI 1.57 to 2.49), and favorable neurologic outcome (aOR 1.44; 95% CI 1.03 to 2.03). The results were comparable in sensitivity and subgroup analyses. CONCLUSION: In nontrauma adult out-of-hospital cardiac arrest in Taipei, successful out-of-hospital intubation was associated with improved odds of sustained return of spontaneous circulation, survival to discharge, and favorable neurologic outcome.
STUDY OBJECTIVE: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest survival in Taipei. METHODS: We analyzed 6 years of Utstein-based registry data from nontrauma adultpatients with out-of-hospital cardiac arrest who underwent out-of-hospital airway management including intubation, laryngeal mask airway, or bag-valve-mask ventilation. The primary analysis was intubation success on patient outcomes. The primary outcome was survival to discharge and the secondary outcomes included sustained return of spontaneous circulation and favorable neurologic survival. Sensitivity analysis was performed with intubation attempts rather than intubation success. Subgroup analysis of advanced life support-serviced districts was also performed. RESULTS: A total of 10,853 cases from 2008 to 2013 were analyzed. Among out-of-hospital cardiac arrestpatients receiving airway management, successful intubation, laryngeal mask airway, and bag-valve-mask ventilation was reported in 1,541, 3,099, and 6,213 cases, respectively. Compared with bag-valve-mask device use, successful out-of-hospital intubation was associated with improved chances of sustained return of spontaneous circulation (adjusted odds ratio [aOR] 1.91; 95% confidence interval [CI] 1.66 to 2.19), survival to discharge (aOR 1.98; 95% CI 1.57 to 2.49), and favorable neurologic outcome (aOR 1.44; 95% CI 1.03 to 2.03). The results were comparable in sensitivity and subgroup analyses. CONCLUSION: In nontrauma adult out-of-hospital cardiac arrest in Taipei, successful out-of-hospital intubation was associated with improved odds of sustained return of spontaneous circulation, survival to discharge, and favorable neurologic outcome.
Authors: Kaashif A Ahmad; Cody L Henderson; Steven G Velasquez; Jaclyn M LeVan; Katy L Kohlleppel; Christina N Stine; Maria R Pierce; Utpal S Bhalala Journal: J Perinatol Date: 2021-02-16 Impact factor: 2.521
Authors: Shu-Hsien Hsu; Jen-Tang Sun; Edward Pei-Chuan Huang; Tatsuya Nishiuchi; Kyoung Jun Song; Benjamin Leong; Nik Hisamuddin Nik Ab Rahman; Pairoj Khruekarnchana; G Y Naroo; Ming-Ju Hsieh; Shu-Hui Chang; Wen-Chu Chiang; Matthew Huei-Ming Ma Journal: PLoS One Date: 2022-08-10 Impact factor: 3.752