Comparison of neurological outcome between tracheal intubation and supraglottic airway device insertion of out-of-hospital cardiac arrest patients: a nationwide, population-based, observational study.
J Emerg Med
; 44(2): 389-97, 2013 Feb.
Article
en En
| MEDLINE
| ID: mdl-22541878
ABSTRACT
BACKGROUND:
The effect of prehospital use of supraglottic airway devices as an alternative to tracheal intubation on long-term outcomes of patients with out-of-hospital cardiac arrest is unclear. STUDYOBJECTIVES:
We compared the neurological outcomes of patients who underwent supraglottic airway device insertion with those who underwent tracheal intubation.METHODS:
We conducted a nationwide population-based observational study using a national database containing all out-of-hospital cardiac arrest cases in Japan over a 3-year period (2005-2007). The rates of neurologically favorable 1-month survival (primary outcome) and of 1-month survival and return of spontaneous circulation before hospital arrival (secondary outcomes) were examined. Multiple logistic regression analyses were performed to adjust for potential confounders. Advanced airway devices were used in 138,248 of 318,141 patients, including an endotracheal tube (ETT) in 16,054 patients (12%), a laryngeal mask airway (LMA) in 34,125 patients (25%), and an esophageal obturator airway (EOA) in 88,069 patients (63%).RESULTS:
The overall rate of neurologically favorable 1-month survival was 1.03% (1426/137,880). The rates of neurologically favorable 1-month survival were 1.14% (183/16,028) in the ETT group, 0.98% (333/34,059) in the LMA group, and 1.04% (910/87,793) in the EOA group. Compared with the ETT group, the rates were significantly lower in the LMA group (adjusted odds ratio 0.77, 95% confidence interval [CI] 0.64-0.94) and EOA group (adjusted odds ratio 0.81, 95% CI 0.68-0.96).CONCLUSIONS:
Prehospital use of supraglottic airway devices was associated with slightly, but significantly, poorer neurological outcomes compared with tracheal intubation, but neurological outcomes remained poor overall.
Texto completo:
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Bases de datos:
MEDLINE
Asunto principal:
Escala de Consecuencias de Glasgow
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Servicios Médicos de Urgencia
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Paro Cardíaco Extrahospitalario
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Manejo de la Vía Aérea
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Intubación Intratraqueal
Tipo de estudio:
Observational_studies
Límite:
Aged
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Female
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Humans
/
Male
País/Región como asunto:
Asia
Idioma:
En
Revista:
J Emerg Med
Asunto de la revista:
MEDICINA DE EMERGENCIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Japón