Association of prehospital airway management technique with survival outcomes of out-of-hospital cardiac arrest patients

Abstract

Introduction Despite numerous studies on airway management in out-of-hospital cardiac arrest (OHCA) patients, the choice of prehospital airway management technique remains controversial. Our study aimed to investigate the association between prehospital advanced airway management and survival outcomes according to a transport time interval (TTI) using nationwide OHCA registry database in Korea. Methods The inclusion criteria were patients with OHCA aged over 18 years old with a presumed cardiac etiology between January 2015 and December 2018. The primary outcome was survival to hospital discharge. The main exposure was the prehospital airway management technique performed by the emergency medical technicians (EMTs), classified as bag-valve mask (BVM), supraglottic airway (SGA), or endotracheal intubation (ETI).We performed multivariable logistic regression analysis and interaction analysis between the type of airway management and TTI for adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Results Of a total of 70,530 eligible OHCA patients, 26,547 (37.6%), 38,391 (54.4%), and 5,592 (7.9%) were managed with BVM, SGA, ETI, respectively. Patients in the SGA and ETI groups had a higher odds of survival to discharge than BVM groups (aOR, 1.11 (1.05–1.16) and 1.13 (1.05–1.23)). And the rates of survival to discharge with SGA and ETI were significantly higher in groups with TTI more than 8 minutes (1.17 (1.08–1.27) and 1.38 (1.20–1.59)). Conclusion The survival to discharge was significantly higher among patients who received ETI and SGA than in those who received BVM. The transport time interval influenced the effect of prehospital airway management on the clinical outcomes after OHCA.

Cardiopulmonary Resuscitation Capacity Building Training for High School Students in Martapura, Banjar Regency

“…Cardiopulmonary resuscitation is very useful for saving life because by giving chest and lung compressions, the patient's circulation can return to the patient's vital organs, especially to the brain and heart itself, accompanied by simple artificial respiration so that ventilation and oxygen exchange occurs in the lungs (H. A. Chen et al, 2022;Jung et al, 2022;. The existence of cardiopulmonary resuscitation provides oxygen intake and blood circulation to body systems, especially organs that are very vital and sensitive to lack of oxygen such as the brain and heart.…”

“…The existence of cardiopulmonary resuscitation provides oxygen intake and blood circulation to body systems, especially organs that are very vital and sensitive to lack of oxygen such as the brain and heart. Cessation of circulation (either a few seconds or even a few minutes) is an emergency condition because the supply of oxygen to the brain stops, and brain hypoxia can occur which results in the ability of the brain's coordination to move autonomic organs to be disturbed, such as heart rate and breathing movements (Borkowska et al, 2021;Jung et al, 2022;Kuo et al, 2022;. This rescue will be very useful if it is done as well as possible.…”

“…The existence of the problem of the low ability of the Lay, including in this case the general public is very low and needs to be empowered (Jellestad et al, 2021;Jung et al, 2022;Wang et al, 2022). This of course has an impact if an emergency case is encountered or occurs in the community, it is possible that ordinary people in the case of Riverside Communities cannot provide cardiopulmonary resuscitation assistance.…”

“…(OHCA) which is the leading cause of death in adults of which 92% of people who experience OHCA are not saved. and happens outside the hospital (Borkowska et al, 2021;Jung et al, 2022;Schluep et al, 2021). Giving the ability to help with cardiopulmonary resuscitation is the right action to prevent this problem from happening.…”

Airway management during cardiac arrest

“…An observational study of 70 530 out-of-hospital cardiac arrests (OHCAs) from the nationwide database in Korea concluded that, after adjustment for confounders, in comparison with use of BMV and insertion of an SGA [adjusted odds ratio (OR), 1.07; 95% confidence interval (CI) 1.01-1.12] or tracheal intubation-adjusted (OR: 1.11, 95% CI 1.03-1.20) was associated with significantly higher survival to hospital discharge [4]. In the fully adjusted statistical model, the odds of a favourable functional outcome were significantly lower in the SGA group compared with the BMV group (adjusted OR 0.85; 95% CI 0.77-0.93) but was not significantly different when comparing tracheal intubation with BMV [adjusted OR (aOR) 0.94; 95% CI 0.80-1.08].…”