The following is a summary of “Airway management in out-of-hospital cardiac arrest: A systematic review and network meta-analysis,” published in the March 2023 issue of Emergency Medicine by Lou, et al.

For a study, researchers sought to evaluate the efficacy of various out-of-hospital airway management methods in improving survival to discharge in patients with out-of-hospital cardiac arrest (OHCA). OHCA is a critical situation where proper airway management is essential. Therefore, they aimed to compare the most commonly used airway management methods for OHCA to identify the most effective one.

To conduct the study, they searched multiple databases, including PubMed, Web of Science, Embase, and the Cochrane Library, for relevant literature published until January 21, 2019. In addition, they included all randomized controlled trials (RCTs) of airway management for OHCA in adults aged ≥16 years without any restrictions on publication date, publication status, or language. The study’s primary outcome was survival to discharge, and the secondary outcomes were overall airway technique success rate, return of spontaneous circulation, and survival to hospital admission.

The study included nine RCTs conducted between 1986 and 2018, involving 13,949 patients. The researchers used network meta-analysis to compare the efficacy of six airway management methods. However, none of the results showed a statistically significant difference in improving survival to discharge.

The study showed that endotracheal intubation (ETI), widely considered the gold standard for airway management in most countries, was not significantly better than other airway management methods in improving survival to discharge in patients with OHCA. The findings of the study suggested that more research was needed to identify more effective methods of airway management to improve patient outcomes.

Reference: sciencedirect.com/science/article/abs/pii/S0735675722007719