Journal
RESUSCITATION
Volume 168, Issue -, Pages 191-198Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.resuscitation.2021.08.015
Keywords
Paediatric out-of-hospital cardiac arrest; Airway management; Endotracheal intubation; Supraglottic ventilation
Categories
Funding
- French Society of Emergency Medicine (SFMU), a patient foundation-Federation Francaise de Cardiologie
- Mutuelle Generale de l'Education Nationale (MGEN)
- University of Lille
- Institute of Health Engineering of Lille
Ask authors/readers for more resources
This study found that in pediatric OHCA, patients who received endotracheal intubation had lower 30-day survival rates and poorer neurological outcomes compared to those who received supraglottic ventilation, without a significant association with return of spontaneous circulation.
Background: Out-of-hospital cardiac arrest (OHCA) in children is associated with a low survival rate. Conclusions in the literature are conflicting regarding the best way to handle ventilation. The purpose of this study was to assess the impact of two airway management strategies, endotracheal intubation (ETI) vs. supraglottic procedure, during cardiopulmonary resuscitation (CPR) on 30-day survival in paediatric OHCA. Methods: This was a retrospective, observational, multicentre, registry-based study conducted from July 2011 to March 2018. All paediatric OHCA patients under 18 years of age and managed by a mobile intensive care unit were included. The primary endpoint was 30-day survival in a weighted population (based on propensity scores). Results: Of 1579 children, 1355 (85.8%) received ETI and 224 (14.2%) received supraglottic ventilation during CPR. We observe a lower 30-day survival in the ETI group compared to the supraglottic group (7.7% vs. 14.3%, absolute dierence, 6.6 percentage points; 95% confidence interval [CI], 2.3-12.0; propensity-adjusted odds ratio [paOR], 0.39; 95% CI, 0.25-0.62; p < 0.001), and also a poorer neurological outcome (paOR, 0.32; 95% CI, 0.19-0.54; p < 0.001). However, we did not identify any significant association between airway management strategy and return of spon-taneous circulation (paOR, 1.15; 95% CI, 0.80-1.65; p = 0.46). Conclusions: The findings of this large cohort study suggest that ETI in paediatric OHCA, although performed by trained physicians, is associated with a worse outcome, regardless of traumatic or non-traumatic aetiology.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available