• Elena-Laura Lemaitre, Laurent Tritsch, Eric Noll, Pierre Diemunsch, and Nicolas Meyer.
• Emergency Department, Hôpitaux Universitaires de Strasbourg, University of Strasbourg, Strasbourg, France; Department of Anaesthesiology, Critical Care and Prehospital Emergency Medicine, Hôpitaux Universitaires de Strasbourg, University of Strasbourg, Strasbourg, France. Electronic address: elenalaura.lemaitre@chru-strasbourg.fr.
• Resuscitation. 2019 Mar 1; 136: 61-69.

Aim Of The StudyThe role of supraglottic devices in airway management in out-of-hospital cardiac arrest (OHCA) remains controversial. The aim of this study was to evaluate the feasibility and effectiveness of intubation through the Intubating Laryngeal Mask Airway (ILMA) when used by prehospital emergency nurses in the setting of OHCA.MethodsWe conducted a prospective, observational trial during 12 years by the Fire Department and prehospital emergency service of the health district of Strasbourg, France. The primary outcome was the success rate of ventilation after intubation through the ILMA, while the secondary outcomes were the success rate of ventilation after insertion of the ILMA and complications related to ILMA placement and intubation. Factors associated with successful intubation were also studied.ResultsDuring the study period, 1464 ILMA placements were attempted by emergency nurses during OHCA. Ventilation was possible in 1250 patients (85.38%) after ILMA placement and in 1078 patients (73.63%) after intubation. Regurgitation of gastric contents occurred in 237 (16.18%) patients, mostly during basic life support. Two factors were predictive of a successful tracheal intubation: the performance of the Chandy maneuver OR = 2.91 (CI: 2.07-3.97) and the number of attempts at intubation OR = 1.95 (CI: 1.43-2.61). Conversely, the number of attempts at ILMA insertion was predictive of an intubation failure OR = 0.11 (CI: 0.07-0.17).ConclusionThe success rate of intubation through the ILMA was high. After ILMA placement, ventilation was possible in 1250 patients (85.38%) and in 1078 patients (73.63%) after intubation.Copyright © 2018 Elsevier B.V. All rights reserved.

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