Acute cardiac care & resuscitation
Risk factors for failure of the first intubation attempt during cardiopulmonary resuscitation in out-of-hospital emergency settings: What about chest compression?
Authors' conclusion
The first intubation attempt failed in 34% of cases, and ongoing chest compressions during intubation was one of six variables associated with the risk of failure. However, this must be weighed against the need for invasive airway management and the negative effects of interrupting chest compressions.
Study context
- Population
- Patients with out-of-hospital cardiac arrest undergoing tracheal intubation during resuscitationOHCA patients analyzed
- Participants
- 848 patients
- Comparison
- Risk factors for failure of the first intubation attempt, in particular continued chest compression during the tracheal intubation (TI) attempt
- Primary endpoint
- Failure of the first intubation attempt
Primary result
As reported in the abstract
First TI attempts failed
291
34.3%
Further findings
Variables associated with increased risk of failure of the first intubation attempt (multivariate analysis)
| OR (95% CI) | ||
|---|---|---|
| Operator who had performed ≤ 50 prior intubationsIncreased risk of failure · multivariate analysis | 2.0 (1.4–2.9) | |
| Male patient genderIncreased risk of failure · multivariate analysis | 1.5 (1.0–2.3) | |
| Small inter-incisor spaceIncreased risk of failure · multivariate analysis | 3.4 (2.2–5.4) | |
| Ear, nose, and throat diseaseIncreased risk of failure · multivariate analysis | 2.8 (1.8–4.4) | |
| VomitingIncreased risk of failure · multivariate analysis | 2.1 (1.4–3.2) | |
| Continued chest compression during the TI attemptIncreased risk of failure · multivariate analysis | 1.6 (1.1–2.3) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Risk factors for failure of the first intubation attempt during cardiopulmonary resuscitation in out-of-hospital emergency settings: What about chest compression? Resuscitation. Published 26 April 2025. doi:10.
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