Original scientific paper
Dose pre-hospital laryngeal mask airway use has a survival benefit in non-shockable cardiac arrest?
CHAN-WEI KUO
; Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
SHEN-CHE LIN
; Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
SHOU-CHIEN HSU
; Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
YI-MING WENG
; Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
CHING-I KUO
; Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
CHIEN-WEI CHENG
; Department of Emergency Medicine, Chang Gung Memorial Hospital, No. 5 Fushing St., Gueishan Shiang, Taoyuan, Taiwan
Abstract
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 effectiveness
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 registration
protocols.
Results. Among the 1912 enrolled patients, most received LMA insertion (72.4%), 108 (5.6%) bag-valve-mask (BVM) ventilation,
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.
Keywords
emergency medical service; out-of-hospital cardiac arrest; laryngeal mask airway; ventilation; cardiopulmonary resuscitation
Hrčak ID:
134092
URI
Publication date:
1.10.2013.
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