J Korean Soc Emerg Med.  2017 Dec;28(6):610-619. 10.0000/jksem.2017.28.6.610.

Should We Convert Prehospital Supraglottic Airway to Endotracheal Tube Immediately in Out-of-Hospital Cardiac Arrest? A Preliminary, Retrospective, Observational Study

• Lim H
• Chon SB

• KMID: 2403280
• DOI: http://doi.org/10.0000/jksem.2017.28.6.610

Abstract

PURPOSE
This study examined whether the immediate conversion of the prehospital supraglottic airway (SGA) to endotracheal intubation (ETI) is associated with the return of spontaneous circulation (ROSC) and survival to discharge among out-of-hospital cardiac arrest (OHCA) victims.
METHODS
This retrospective observational study included OHCA victims aged ≥18 years who were treated from 2014 to 2016. The patient-, prehospital arrest-, and emergency department (ED)-related variables were collected based on the Utstein template. The immediate conversion of SGA to ETI was defined when it had been initiated within ≤2 minutes after arrival at the ED. To investigate the factors related to ROSC and survival to discharge, multiple logistic regression analysis of the immediate conversion of SGA to ETI and variables showing a difference (p < 0.15) on the Mann-Whitney U and chi-square test was performed.
RESULTS
A total of 129 patients were enrolled, with a median age of 59 years (interquartile range, 51 to 72 years). Of these, 30 (23.3%) were female, 41 (31.8%) achieved ROSC, and 7 (5.4%) survived to discharge. Sixty-nine (53.5%) received immediate conversion showing no differences in the demographic and clinical characteristics compared to the delayed conversion group. Multiple logistic regression analysis showed that ROSC was related to the existence of lung disease, presence of witnesses, and a cardiopulmonary resuscitation duration ≤15 minutes at the ED, whereas the survival to discharge was associated with the prehospital shockable initial rhythm. Neither ROSC nor survival to discharge were related to the immediate conversion of SGA to ETI.
CONCLUSION
The immediate conversion of prehospital SGA to ETI at ED in an OHCA victim might be unrelated to ROSC and survival to discharge.

Keyword

Airway management; Cardiopulmonary resuscitation; Intubation; intratracheal; Laryngeal masks; Out-ofhospital cardiac arrest

MeSH Terms

Airway Management
Cardiopulmonary Resuscitation
Emergency Service, Hospital
Female
Humans
Intubation
Intubation, Intratracheal
Laryngeal Masks
Logistic Models
Lung Diseases
Observational Study*
Out-of-Hospital Cardiac Arrest*
Retrospective Studies*