Dose pre-hospital laryngeal mask airway use has a survival benefit in non-shockable cardiac arrest?
1,Department of Emergency Medicine Chang Gung Memorial Hospital
DOI: 10.22514/SV91.042014.4 Vol.9,Issue 1,April 2014 pp.27-32
Published: 30 April 2014
Background. Whether pre-hospital laryngeal mask airway (LMA) use poses a survival benefit and should be approved as routine airway management in non-shockable cardiac arrest is of major concern. The present study examined the effective-ness of LMA, in comparison to other pre-hospital airway management on individuals who have experienced non-shockable cardiac arrest.
Methods. Adult patients who experienced non-shockable cardiac arrest with activation of the emergency medical service (EMS) made up our study cohort in Taoyuan, Taiwan. The data were abstracted from EMS records and cardiac arrest regi-stration protocols.
Results. Among the 1912 enrolled patients, most received LMA insertion (72.4%), 108 (5.6%) bag-valve-mask (BVM) venti-lation, 376 (19.7%) high-flow oxygen non-rebreather facemask, and only 44 (2.3%) received endotracheal tube intubation (ETI). With regard to survival to discharge, no significant differences in prevalence were evident among the groups: 2.8% of oxygen facial mask, 1.1% of BVM, 2.1% of LMA, and 4.5% of the ETI group survived to discharge (p = 0.314). In comparison to oxygen facial mask use, different types of airway management remained unassociated with survival to discharge after adjusting for variables by logistic regression analysis (BVM: 95% confidence interval [CI], 0.079 – 1.639 [p = 0.186]; LMA: 95% CI, 0.220–2.487 [p = 0.627]; ETI: 95% CI, 0.325–17.820 [p = 0.390]). The results of Hosmer-Lemeshow goodness-of-fit test of logistic regression model revealed good calibration.
Conclusions. Pre-hospital LMA use was not associated with additional survival to discharge compared with facial oxygen mask, BVM, or ETI following non-shockable cardiac arrest.
emergency medical ser-vice, out-of-hospital cardiac arrest, laryngeal mask airway, ventilation, cardiopulmonary resuscitation
SHEN-CHE LIN,SHOU-CHIEN HSU,YI-MING WENG,CHING-I KUO,CHIEN-WEI CHENG,CHAN-WEI KUO. Dose pre-hospital laryngeal mask airway use has a survival benefit in non-shockable cardiac arrest?. Signa Vitae. 2014. 9(1);27-32.
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