• Resuscitation · Apr 2024

    Association of pre-hospital tracheal intubation with outcomes after out-of-hospital cardiac arrest by drowning comparing to supraglottic airway device: a nationwide propensity score-matched cohort study.

    • Satoshi Yoshimura, Takeyuki Kiguchi, Norihiro Nishioka, Nobuhiro Ikeda, Masayasu Takegawa, Nobuhiro Miyamae, Yasuyuki Sumida, Tetsuhisa Kitamura, and Taku Iwami.
    • Department of Emergency Medicine, Rakuwakai Otowa Hospital, Kyoto, Japan; Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan.
    • Resuscitation. 2024 Apr 1; 197: 110129110129.

    Aim Of The StudyThis study aimed to compare the survival outcomes of adult patients with out-of-hospital cardiac arrest (OHCA) by drowning who were treated with either endotracheal intubation (ETI) or a supraglottic airway (SGA) device.MethodsWe compared the outcomes of patients with OHCA by drowning according to airway management using a Japanese nationwide population-based registry (All-Japan Utstein Registry). Adult patients with OHCA treated in 2014-2020 with advanced airway management (ETI or SGA) were included. Patients who received ETI during cardiopulmonary resuscitation were matched with those treated with SGA based on propensity scores in a 1:1 ratio with a 0.2 calliper width. The outcome measures were the return of spontaneous circulation (ROSC), survival at one month, and favourable neurological outcomes defined as a Cerebral Performance Category Scale score of 1 or 2.ResultsOf the 11,703 eligible patients, 4,467 (38.2%) and 7,236 (61.8%) underwent ETI and SGA, respectively. A total of 3,566 patients in each cohort were matched. The ROSC rate was higher in those treated with ETI versus SGA (207/3,566 [5.8%] versus 167/3,566 [4.7%], respectively; adjusted odds ratio, 1.25; 95% confidence interval [CI], 1.02-1.55). There was no intergroup difference in one-month survival or favourable neurological outcome (32/3566 [0.90%] versus 34/3566 [0.95%]; odds ratio, 0.94; 95% CI, 0.58-1.53; and 9/3566 [0.25%] versus 8/3566 [0.22%]; odds ratio, 1.13; 95% CI, 0.43-2.92), respectively.ConclusionsIn this propensity score-matched study of adult OHCA by drowning, ETI compared to SGA was associated with ROSC but not associated with survival and favourable neurological outcomes at one month.Copyright © 2024 Elsevier B.V. All rights reserved.

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