Acute cardiac care & resuscitation
Supraglottic airway devices are associated with asphyxial physiology after prolonged CPR in patients with refractory Out-of-Hospital cardiac arrest presenting for extracorporeal cardiopulmonary resuscitation
Authors' conclusion
ETI was associated with improved oxygenation and ventilation after prolonged CPR. This resulted in increased rate of candidacy for ECPR and increased neurologically favorable survival to discharge with ETI compared to SGA.
Study context
- Population
- Adults with refractory OHCA due to shockable presenting rhythms presenting for extracorporeal cardiopulmonary resuscitation (ECPR)
- Participants
- 420 adults
- Exposure
- Endotracheal intubation (ETI) vs supraglottic airways (SGA)
- ETIn = 179
- SGAn = 204reference
- Outcome
- Pre-cannulation arterial PaO2 upon arrival to the ECMO cannulation center
Methodological detailsconsecutive patients, single programme (University of Minnesota ECPR program)
- Consecutive patients
- Single programme (University of Minnesota ECPR program)
Main finding
As reported in the abstract
PaO2
P = 0.001
Observational data: associations, not effects.
Secondary outcomes
PaCO2
P < 0.001
Eligibility for VA-ECMO
P = 0.008
Neurologically favorable survival to hospital discharge (VA-ECMO eligible patients)
P = 0.02
Median
| Outcome | ETI | SGA | P value |
|---|---|---|---|
| pH | 7.03 | 6.93 | P < 0.001 |
Original publication
Supraglottic airway devices are associated with asphyxial physiology after prolonged CPR in patients with refractory Out-of-Hospital cardiac arrest presenting for extracorporeal cardiopulmonary resuscitation. Resuscitation. Published 17 March 2023. doi:10.
Summarised from the published abstract; every number is checked against it