Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest

Kajino, Kentaro; Iwami, Taku; Kitamura, Tetsuhisa; Daya, Mohamud; Ong, Marcus E.H.; Nishiuchi, Tatsuya; Hayashi, Yasuyuki; Sakai, Tomohiko; Shimazu, Takeshi; Hiraide, Atsushi; Kishi, Masashi; Yamayoshi, Shigeru

doi:https://doi.org/10.1186/cc10483

Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest

Kajino, Kentaro; Iwami, Taku; Kitamura, Tetsuhisa et al.

Critical Care, 2011, 15(5), R236

アクセス数:1,291件（2025-10-24 04:00 集計）

固定URL: https://hdl.handle.net/11094/78418

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タイトル	Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest
著者	著者名 Kajino, Kentaro
	NRID 1000060437291 1000060437291 著者名 Iwami, Taku
	NRID 1000030639810 1000030639810 ORCID 0000-0003-0107-0580 0000-0003-0107-0580 researchmap permalink Kitamura_T Kitamura_T Scopus Author ID 22234282700 22234282700 著者名 Kitamura, Tetsuhisa
	著者名 Daya, Mohamud
	著者名 Ong, Marcus E.H.
	NRID 1000060588804 1000060588804 著者名 Nishiuchi, Tatsuya
	著者名 Hayashi, Yasuyuki
	NRID 1000050456985 1000050456985 researchmap permalink sakaitomohiko sakaitomohiko Scopus Author ID 35746769000 35746769000 著者名 Sakai, Tomohiko
	NRID 1000050196474 1000050196474 著者名 Shimazu, Takeshi
	NRID 1000020199037 1000020199037 著者名 Hiraide, Atsushi
	著者名 Kishi, Masashi
	著者名 Yamayoshi, Shigeru
キーワード等	Advanced airway
	Cardiac arrest
	Endotracheal intubation
	Pre-hospital
	Resuscitation
	Supraglottic airway
内容	Kajino, K., Iwami, T., Kitamura, T. et al. Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest. Crit Care 15, R236 (2011). https://doi.org/10.1186/cc10483
抄録	Introduction: Both supraglottic airway devices (SGA) and endotracheal intubation (ETI) have been used by emergency life-saving technicians (ELST) in Japan to treat out-of-hospital cardiac arrests (OHCAs). Despite traditional emphasis on airway management during cardiac arrest, its impact on survival from OHCA and time dependent effectiveness remains unclear.Methods: All adults with witnessed, non-traumatic OHCA, from 1 January 2005 to 31 December 2008, treated by the emergency medical services (EMS) with an advanced airway in Osaka, Japan were studied in a prospective Utstein-style population cohort database. The primary outcome measure was one-month survival with neurologically favorable outcome. The association between type of advanced airway (ETI/SGA), timing of device placement and neurological outcome was assessed by multiple logistic regression.Results: Of 7,517 witnessed non-traumatic OHCAs, 5,377 cases were treated with advanced airways. Of these, 1,679 were ETI while 3,698 were SGA. Favorable neurological outcome was similar between ETI and SGA (3.6% versus 3.6%, P = 0.95). The time interval from collapse to ETI placement was significantly longer than for SGA (17.2 minutes versus 15.8 minutes, P < 0.001). From multivariate analysis, early placement of an advanced airway was significantly associated with better neurological outcome (Adjusted Odds Ratio (AOR) for one minute delay, 0.91, 95% confidence interval (CI) 0.88 to 0.95). ETI was not a significant predictor (AOR 0.71, 95% CI 0.39 to 1.30) but the presence of an ETI certified ELST (AOR, 1.86, 95% CI 1.04 to 3.34) was a significant predictor for favorable neurological outcome.Conclusions: There was no difference in neurologically favorable outcome from witnessed OHCA for ETI versus SGA. Early airway management with advanced airway regardless of type and rhythm was associated with improved outcomes.
出版者	BioMed Central Ltd.
収録物名	Critical Care
巻(号)	15(5)
ページ	R236
刊行年月	2011-10-10
言語	英語
ハンドルURL	https://hdl.handle.net/11094/78418
PISSN	13648535
eISSN	1466609X
NCID	AA10617567
関連情報 (isIdenticalTo)	DOI (出版社版) https://doi.org/10.1186/cc10483
関連情報 (isIdenticalTo)	PMID 21985431
アクセス権	open access
権利情報	© 2011 Kajino et al.; licensee BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 2.0 Generic License.
出版タイプ	Version of Record
カテゴリ	学術雑誌論文 Journal Article

資源タイプ	学術雑誌論文
ローカル資源タイプ	学術雑誌論文
DCMI資源タイプ	text
DCTERMS.bibliographicCitation	Critical Care. 2011, 15(5), p. R236
DC.title	Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest
DC.creator	Kajino, Kentaro
	Iwami, Taku
	Kitamura, Tetsuhisa
	Daya, Mohamud
	Ong, Marcus E.H.
	Nishiuchi, Tatsuya
	Hayashi, Yasuyuki
	Sakai, Tomohiko
	Shimazu, Takeshi
	Hiraide, Atsushi
	Kishi, Masashi
	Yamayoshi, Shigeru
DC.publisher	BioMed Central Ltd.
DC.language' scheme='DCTERMS.RFC1766	英語
DC.type' scheme='DCTERMS.DCMIType	text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2011-10-10
DC.identifier	https://doi.org/10.1186/cc10483
DC.subject	Advanced airway
	Cardiac arrest
	Endotracheal intubation
	Pre-hospital
	Resuscitation
	Supraglottic airway
DC.description	Kajino, K., Iwami, T., Kitamura, T. et al. Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest. Crit Care 15, R236 (2011). https://doi.org/10.1186/cc10483
DCTERMS.abstract	Introduction: Both supraglottic airway devices (SGA) and endotracheal intubation (ETI) have been used by emergency life-saving technicians (ELST) in Japan to treat out-of-hospital cardiac arrests (OHCAs). Despite traditional emphasis on airway management during cardiac arrest, its impact on survival from OHCA and time dependent effectiveness remains unclear.Methods: All adults with witnessed, non-traumatic OHCA, from 1 January 2005 to 31 December 2008, treated by the emergency medical services (EMS) with an advanced airway in Osaka, Japan were studied in a prospective Utstein-style population cohort database. The primary outcome measure was one-month survival with neurologically favorable outcome. The association between type of advanced airway (ETI/SGA), timing of device placement and neurological outcome was assessed by multiple logistic regression.Results: Of 7,517 witnessed non-traumatic OHCAs, 5,377 cases were treated with advanced airways. Of these, 1,679 were ETI while 3,698 were SGA. Favorable neurological outcome was similar between ETI and SGA (3.6% versus 3.6%, P = 0.95). The time interval from collapse to ETI placement was significantly longer than for SGA (17.2 minutes versus 15.8 minutes, P < 0.001). From multivariate analysis, early placement of an advanced airway was significantly associated with better neurological outcome (Adjusted Odds Ratio (AOR) for one minute delay, 0.91, 95% confidence interval (CI) 0.88 to 0.95). ETI was not a significant predictor (AOR 0.71, 95% CI 0.39 to 1.30) but the presence of an ETI certified ELST (AOR, 1.86, 95% CI 1.04 to 3.34) was a significant predictor for favorable neurological outcome.Conclusions: There was no difference in neurologically favorable outcome from witnessed OHCA for ETI versus SGA. Early airway management with advanced airway regardless of type and rhythm was associated with improved outcomes.
DC.rights	© 2011 Kajino et al.; licensee BioMed Central Ltd. This article is licensed under a Creative Commons Attribution 2.0 Generic License.
DC.format	78418
citation_title	Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest
citation_author	Kajino, Kentaro
	Iwami, Taku
	Kitamura, Tetsuhisa
	Daya, Mohamud
	Ong, Marcus E.H.
	Nishiuchi, Tatsuya
	Hayashi, Yasuyuki
	Sakai, Tomohiko
	Shimazu, Takeshi
	Hiraide, Atsushi
	Kishi, Masashi
	Yamayoshi, Shigeru
citation_publisher	BioMed Central Ltd.
citation_language	英語
citation_date	2011-10-10
citation_journal_title	Critical Care
citation_volume	15
citation_issue	5
citation_firstpage	R236
citation_doi	https://doi.org/10.1186/cc10483
citation_pmid	21985431
citation_public_url	https://hdl.handle.net/11094/78418

Comparison of supraglottic airway versus endotracheal intubation for the pre-hospital treatment of out-of-hospital cardiac arrest

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