The following is a summary of “Association between prehospital airway type and oxygenation and ventilation in out-of-hospital cardiac arrest,” published in the March 2023 issue of Emergency Medicine by Song, et al.

For a study, researchers sought to assess the relationship between the kind of prehospital airway and out-of-hospital cardiac arrest (OHCA) oxygenation and ventilation.

Between October 2015 and June 2021, patients with OHCA who visited emergency departments (EDs) were included in the retrospective observational analysis. Endotracheal intubation (ETI), supraglottic airway (SGA), and bag-valve-mask (BVM) ventilation were the three prehospital airway types used to classify the study groups. First arterial blood gas (ABG) test results showed satisfactory oxygenation with the partial pressure of oxygen (PaO2) (OHCA) 60 mmHg. The partial pressure of carbon dioxide (PaCO2) ≤45 mmHg indicated excellent ventilation as a secondary result. The adjusted odds ratio (AOR) and 95% CI were calculated using multivariate logistic regression.

About 7,372 patients were included over the research period, including 4,847 patients who underwent SGA, 706 who received ETI, and 1,819 who received BVM treatment. The ETI group demonstrated a higher AOR than the BVM group in a multivariable logistic regression analysis for successful oxygenation outcomes (AOR [95% CIs]: 1.30 [1.06-1.59] in ETI and 1.05 [0.93-1.20] in SGA groups). When compared to the BVM group, the ETI group had a higher AOR, and the SGA group had a lower AOR (AOR [95% CIs] 1.33 [1.02-1.74] in the ETI group and 0.83 (0.70-0.99) in the SGA group). The survival rate to discharge did not differ significantly.

In comparison to BVM, ETI was strongly related to excellent ventilation and oxygenation in patients with OHCA, especially during long travels. Therefore, it should be considered when choosing the prehospital advanced airway treatment for patients with OHCA.

Reference: sciencedirect.com/science/article/pii/S0735675722007665