Acute cardiac care & resuscitation
Does the effectiveness of advanced airway management depend on initial cardiac arrest rhythm? A secondary analysis of the pragmatic airway resuscitation trial
Authors' conclusion
Prehospital advanced airway management strategy (ETI vs. LT) was not significantly associated with outcomes regardless of initial cardiac rhythm.
Study context
- Population
- Adults with out-of-hospital cardiac arrest (OHCA), stratified by initial rhythm (shockable, pulseless electrical activity (PEA), asystole); AED non-shockable and unknown rhythms excludedof 3004 in parent trial
- Participants
- 2,847 adults
- Comparison
- Laryngeal tube (LT) vs endotracheal intubation (ETI) for initial advanced airway management
- Primary endpoint
- 72-h survival
- Follow-up
- 72 h
Methodological detailspragmatic, subgroup analysis by initial rhythm
- Pragmatic
- Subgroup analysis by initial rhythm
Primary result
As reported in the abstract
72-h survival, by initial rhythm
LT vs ETIAdjusted odds ratio (CI)
Shockable (n = 575, 20.2 %)
1.30(0.91–1.67)
PEA (n = 671, 23.6 %)
0.97(0.65–1.45)
Asystole (n = 1601, 56.2 %)
1.13(0.79–1.64)
Secondary outcomes
Return of spontaneous circulation (ROSC) at ED arrival, survival to discharge, survival with good neurological function (mRS ≤3)
- No significant interaction between airway strategy and initial rhythm
Original publication
Does the effectiveness of advanced airway management depend on initial cardiac arrest rhythm? A secondary analysis of the pragmatic airway resuscitation trial. Resuscitation. Published 7 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it