Abstract：
Supraglottic airway devices are increasingly used during the resuscitation of out-of-hospital cardiac arrest (OHCA) patients in the United States and worldwide. In this study, we aimed to compare the neurologic outcomes of OHCA patients managed with the King Laryngeal Tube (King LT) to the neurologic outcomes of patients managed with the iGel.
We used the Cardiac Arrest Registry to Enhance Survival (CARES) public use research dataset for our analysis. Non-traumatic OHCA cases with attempted EMS resuscitation enrolled from 2013-2021 were included. We used two-level mixed effects multivariable logistic regression analyses with treating EMS agency as the random effect to determine the association between supraglottic airway device and outcome. The primary outcome was survival with a Cerebral Performance Category (CPC) score of 1 or 2 at discharge. Secondary outcomes included survival to hospital admission and survival to hospital discharge. Age, sex, calendar year of OHCA, initial ECG rhythm, witnessed status (unwitnessed, bystander witnessed, 9-1-1 responder witnessed), bystander CPR, response interval, and OHCA location (private/home, public, institutional) were used as covariables.
In comparison to use of the King LT, use of the iGel was associated with greater neurologically favorable survival (aOR: 1.45 [1.33, 1.58]). In addition, use of the iGel was associated with greater survival to hospital admission (1.07 [1.02, 1.12]) and survival to hospital discharge (1.35 [1.26, 1.46]).
This study adds to the body of literature suggesting that use of the iGel during OHCA resuscitation is associated with better outcomes than use of the King LT.
We used the Cardiac Arrest Registry to Enhance Survival (CARES) public use research dataset for our analysis. Non-traumatic OHCA cases with attempted EMS resuscitation enrolled from 2013-2021 were included. We used two-level mixed effects multivariable logistic regression analyses with treating EMS agency as the random effect to determine the association between supraglottic airway device and outcome. The primary outcome was survival with a Cerebral Performance Category (CPC) score of 1 or 2 at discharge. Secondary outcomes included survival to hospital admission and survival to hospital discharge. Age, sex, calendar year of OHCA, initial ECG rhythm, witnessed status (unwitnessed, bystander witnessed, 9-1-1 responder witnessed), bystander CPR, response interval, and OHCA location (private/home, public, institutional) were used as covariables.
In comparison to use of the King LT, use of the iGel was associated with greater neurologically favorable survival (aOR: 1.45 [1.33, 1.58]). In addition, use of the iGel was associated with greater survival to hospital admission (1.07 [1.02, 1.12]) and survival to hospital discharge (1.35 [1.26, 1.46]).
This study adds to the body of literature suggesting that use of the iGel during OHCA resuscitation is associated with better outcomes than use of the King LT.
摘要：
目的：声门上气道装置在美国和世界范围内越来越多地用于院外心脏骤停（OHCA）患者的复苏。在这项研究中,我们的目的是比较使用King喉管(KingLT)治疗的OHCA患者的神经系统结局与使用iGel治疗的患者的神经系统结局.
方法：我们使用心脏骤停登记处提高生存率（CARES）公共使用研究数据集进行分析。纳入2013-2021年纳入的尝试EMS复苏的非创伤性OHCA病例。我们使用两级混合效应多变量逻辑回归分析，将EMS治疗作为随机效应，以确定声门上气道装置与结果之间的关联。主要结果是出院时脑功能分类（CPC）评分为1或2的生存率。次要结局包括生存至入院和生存至出院。年龄,性别,OHCA的日历年,初始心电图节律,见证地位(未见证，旁观者见证,9-1-1响应者见证)，旁观者心肺复苏术,响应间隔,和OHCA位置(私人/家庭，public,机构)被用作协变量。
结果：与使用KingLT相比，iGel的使用与更高的神经有利生存率相关(aOR:1.45[1.33,1.58]).此外,iGel的使用与更高的生存至入院(1.07[1.02,1.12])和更高的生存至出院(1.35[1.26,1.46])相关.
结论：这项研究增加了大量文献，表明在OHCA复苏期间使用iGel比使用KingLT具有更好的预后。
方法：我们使用心脏骤停登记处提高生存率（CARES）公共使用研究数据集进行分析。纳入2013-2021年纳入的尝试EMS复苏的非创伤性OHCA病例。我们使用两级混合效应多变量逻辑回归分析，将EMS治疗作为随机效应，以确定声门上气道装置与结果之间的关联。主要结果是出院时脑功能分类（CPC）评分为1或2的生存率。次要结局包括生存至入院和生存至出院。年龄,性别,OHCA的日历年,初始心电图节律,见证地位(未见证，旁观者见证,9-1-1响应者见证)，旁观者心肺复苏术,响应间隔,和OHCA位置(私人/家庭，public,机构)被用作协变量。
结果：与使用KingLT相比，iGel的使用与更高的神经有利生存率相关(aOR:1.45[1.33,1.58]).此外,iGel的使用与更高的生存至入院(1.07[1.02,1.12])和更高的生存至出院(1.35[1.26,1.46])相关.
结论：这项研究增加了大量文献，表明在OHCA复苏期间使用iGel比使用KingLT具有更好的预后。
