HCPLive Network

Prehospital Advanced Airway Use in Patients Suffering Cardiac Arrest Hurts Neurologic Outcomes

TUESDAY, Jan. 15 (HealthDay News) -- For adults with out-of-hospital cardiac arrest (OHCA), the odds of favorable neurologic outcome are significantly reduced with advanced airway management versus conventional bag-valve-mask ventilation, according to a study published in the Jan. 16 issue of the Journal of the American Medical Association.

Kohei Hasegawa, M.D., M.P.H., from Massachusetts General Hospital and Harvard Medical School in Boston, and colleagues conducted a prospective, nationwide, population-based study involving 649,654 consecutive adult patients in Japan with OHCA to examine whether prehospital advanced airway management correlates with favorable neurologic outcome one month after OHCA. Fifty-seven percent of the 649,359 eligible participants underwent bag-valve-mask ventilation, and 43 percent underwent advanced airway management, including endotracheal intubation (6 percent) and use of supraglottic airways (37 percent).

The researchers found that in the full cohort the rate of favorable neurologic outcome was significantly reduced for the advanced airway group versus the bag-valve-mask group (1.1 versus 2.9 percent; odds ratio [OR], 0.38). After adjustment for multiple variables, including age, sex, and etiology of arrest, advanced airway management was associated with significantly reduced odds of favorable neurological outcome (OR, 0.38). The odds of neurologically favorable survival were significantly reduced for management with endotracheal intubation (OR, 0.41) and supraglottic airways (OR, 0.38) in the full cohort and in a propensity score-matched cohort (adjusted OR, 0.45 and 0.36, respectively).

"Among adult patients with OHCA, any type of advanced airway management was independently associated with decreased odds of neurologically favorable survival compared with conventional bag-valve-mask ventilation," the authors write.

Full Text (subscription or payment may be required)
Editorial (subscription or payment may be required)

Copyright © 2013 HealthDay. All rights reserved.

Further Reading
An analysis of cardiac catheterization laboratories in the United States, providing a current snapshot of patient characteristics and presentation as well as current practice, has been published online Oct. 17 in the Journal of the American College of Cardiology.
Bystanders are more likely to initiate cardiopulmonary resuscitation on patients who have a cardiac arrest in high-income white neighborhoods, according to a study published in the Oct. 25 issue of the New England Journal of Medicine.
Recently released guidelines for the diagnosis and management of stable ischemic heart disease focus on evaluation and testing, risk factor modification, medical therapy and other therapeutic options, and follow-up.
For patients with out-of-hospital cardiac arrest who do not regain consciousness, an invasive strategy characterized by emergency coronary angiography and subsequent percutaneous coronary intervention, if indicated, is associated with improved in-hospital survival, according to a study published in the Dec. 15 issue of The American Journal of Cardiology.
Over the past decade, there has been a trend toward improved survival and a decrease in neurologic disability following in-hospital cardiac arrest, according to a study published in the Nov. 15 issue of the New England Journal of Medicine.
Annual list highlights key studies and research that contribute to the prevention and treatment of cardiovascular diseases and stroke.
For women without coronary heart disease at baseline, smoking, even in small quantities, is associated with a significantly increased risk of sudden cardiac death, according to research published online Dec. 11 in Circulation.
More Reading