Charles D Deakin1, Jerry P Nolan2, Chen Ji3, Rachael T Fothergill4, Tom Quinn5, Andy Rosser6, Ranjit Lall3, Gavin D Perkins7. 1. South Central Ambulance Service NHS Foundation Trust, Otterbourne, SO21 2RU, UK; NIHR Southampton Respiratory Biomedical Research Unit, Southampton, SO16 6YD, UK. Electronic address: charlesdeakin@doctors.org.uk. 2. Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK; Royal United Hospital, Bath, BA1 3NG, UK. 3. Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK. 4. Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK; London Ambulance Service NHS Trust, 8-20 Pocock Street, London, SE1 0BW, UK; Kingston University and St George's, University of London, 6th Floor, Hunter Wing, Cranmer Terrace, London, SW17 0RE, UK. 5. Kingston University and St George's, University of London, 6th Floor, Hunter Wing, Cranmer Terrace, London, SW17 0RE, UK. 6. West Midlands Ambulance Service University NHS Foundation Trust, Brierley Hill, West Midlands, DY5 1LX, UK. 7. Warwick Clinical Trials Unit, University of Warwick, Coventry, CV4 7AL, UK; Heartlands Hospital, University Hospitals Birmingham, Birmingham, B9 5SS, UK.
Abstract
INTRODUCTION:Good quality basic life support (BLS) is associated with improved outcome from cardiac arrest. Chest compression fraction (CCF) is a BLS quality indicator, which may be influenced by the type of airway used. We aimed to assess CCF according to the airway strategy in the PARAMEDIC2 study: no advanced airway, supraglottic airway (SGA), tracheal intubation, or a combination of the two. Our hypothesis was that tracheal intubation was associated with a decrease in the CCF compared with alternative airway management strategies. METHODS: PARAMEDIC2 was a multicentre double-blinded placebo-controlled trial of adrenaline vs placebo in out-of-hospital cardiac arrest. Data showing compression rate and ratio from patients recruited by London Ambulance Service (LAS) as part of this study was collated and analysed according to the advanced airway used during the resuscitation attempt. RESULTS: CPR process data were available from 286/ 2058 (13.9%) of the total patients recruited by LAS. The mean compression rate for the first 5 min of data recording was the same in all groups (P = 0.272) and ranged from 104.2 (95% CI of mean: 100.5, 107.8) min-1 to 108.0 (95% CI of mean: 105.1, 108.3) min-1. The mean compression fraction was also similar across all groups (P = 0.159) and ranged between 74.7% and 78.4%. There was no difference in the compression rates and fractions across the airway management groups, regardless of the duration of CPR. CONCLUSION: There was no significant difference in the compression fraction associated with the airway management strategy.
RCT Entities:
INTRODUCTION: Good quality basic life support (BLS) is associated with improved outcome from cardiac arrest. Chest compression fraction (CCF) is a BLS quality indicator, which may be influenced by the type of airway used. We aimed to assess CCF according to the airway strategy in the PARAMEDIC2 study: no advanced airway, supraglottic airway (SGA), tracheal intubation, or a combination of the two. Our hypothesis was that tracheal intubation was associated with a decrease in the CCF compared with alternative airway management strategies. METHODS: PARAMEDIC2 was a multicentre double-blinded placebo-controlled trial of adrenaline vs placebo in out-of-hospital cardiac arrest. Data showing compression rate and ratio from patients recruited by London Ambulance Service (LAS) as part of this study was collated and analysed according to the advanced airway used during the resuscitation attempt. RESULTS: CPR process data were available from 286/ 2058 (13.9%) of the total patients recruited by LAS. The mean compression rate for the first 5 min of data recording was the same in all groups (P = 0.272) and ranged from 104.2 (95% CI of mean: 100.5, 107.8) min-1 to 108.0 (95% CI of mean: 105.1, 108.3) min-1. The mean compression fraction was also similar across all groups (P = 0.159) and ranged between 74.7% and 78.4%. There was no difference in the compression rates and fractions across the airway management groups, regardless of the duration of CPR. CONCLUSION: There was no significant difference in the compression fraction associated with the airway management strategy.