BComparison of supraglottic airway device vs. endotracheal intubation for initial airway management in out-of-hospital cardiac arrest: a systematic review and meta-analysis.

Yan Tao, Juxia Zhang, Lei Feng
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Abstract

Introduction: Out-of-hospital cardiac arrest (OHCA) is characterized by the cessation of mechanical cardiac activity and voluntary circulation occurring outside of a hospital setting, making it the leading cause of death worldwide. Recently, the optimal approach to airway management has been a subject of controversy.

Methods: Follow PRISMA guidelines for systematic evaluation and meta-analysis. The primary outcome was survival assessed by 4 measures: Restoration of spontaneous circulation, survival to hospital or emergency department, evaluation of functional recovery after PCR (measured at both discharge and 3 months after PCR), and neurological function score at discharge.

Results: A total of 6 RCTs (14,205 patients) were included in the systematic review and 4 RCTs (13,053 patients) were included in the meta-analysis. 5 studies (83.3%)of RCTs with ETI controls were notable for their high quality, with low risk of bias judged in all 7 domains of the risk assessment scale. Showed an advantage of SGA (compared to ETI) with potential for ROSC (95% CI [1.02 to 1.18], I2 = 48%, p = 0.01) and survival to hospital or emergency department(95% CI [1.01 to 1.17], I2 = 12%, p = 0.02).

Conclusions: This systematic review and meta-analysis found a significant association between SGA and the possibility of obtaining ROSC and reaching the hospital or emergency department after CPR in OHCA.

院外心脏骤停初始气道管理中声门上气道装置与气管内插管的比较:一项系统回顾和荟萃分析。
院外心脏骤停(OHCA)的特点是在医院外发生的心脏机械活动和自愿循环停止,使其成为世界范围内死亡的主要原因。近年来,气道管理的最佳方法一直是争议的主题。方法:按照PRISMA指南进行系统评价和meta分析。主要结局是通过4项指标评估生存:自发循环恢复、到医院或急诊科的生存、PCR后功能恢复评估(在出院时和PCR后3个月测量)、出院时神经功能评分。结果:系统评价共纳入6项rct(14205例患者),meta分析纳入4项rct(13053例患者)。纳入ETI对照的rct中有5项研究(83.3%)质量较高,在风险评估量表的7个领域均判定偏倚风险较低。显示SGA的优势(与ETI相比),潜在的ROSC (95% CI [1.02 ~ 1.18], I2 = 48%, p = 0.01)和到医院或急诊科的生存率(95% CI [1.01 ~ 1.17], I2 = 12%, p = 0.02)。结论:本系统综述和荟萃分析发现,SGA与OHCA患者心肺复苏术后获得ROSC和到达医院或急诊科的可能性之间存在显著关联。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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