HealthDay News — For patients with out-of-hospital cardiac arrest (OHCA), 72-hour survival is better with initial laryngeal tube (LT) insertion compared to endotracheal intubation (ETI), while a supraglottic airway device (SGA) is no better than tracheal intubation (TI) for functional outcome at 30 days, according to 2 studies published in the Aug. 28 issue of the Journal of the American Medical Association.
Henry E. Wang, MD, from the University of Texas Health Science Center at Houston, and colleagues compared the effectiveness of an initial LT insertion vs initial ETI in 3004 adults with OHCA (1505 and 1499 patients, respectively). The researchers found that the rates of initial airway success were 90.3 and 51.6% with LT and ETI, respectively. Seventy-two hour survival was 18.3 and 15.4% in the LT and ETI groups, respectively (adjusted difference, 2.9%; 95% confidence interval, 0.2 to 5.6%; P = 0.04).
Jonathan R. Benger, MD, from the University of the West of England in Bristol, United Kingdom, and colleagues randomized paramedics to use SGA (759 paramedics; 4886 patients) or TI (764 paramedics; 4410 patients) as the initial advanced airway management strategy in OHCA. The researchers found that 6.4 and 6.8% of patients in the SGA and TI groups, respectively, had a good outcome (modified Rankin Scale score range, 0 to 3) at hospital discharge or 30 days after OHCA (adjusted risk difference, −0.6%; 95% confidence interval, −1.6 to 0.4%).
“Among patients with out-of-hospital cardiac arrest, randomization to a strategy of advanced airway management with a supraglottic airway device compared with tracheal intubation did not result in a favorable functional outcome at 30 days,” Benger and colleagues write.
Several authors from the Wang study disclosed financial ties to the medical device industry.