Effects of Bag-mask versus Advanced Airway Ventilation for Patients Undergoing Prolonged Cardiopulmonary Resuscitation in Pre-hospital Setting
The Journal of Emergency Medicine, 10/31/2011
Nagao T et al. – Advanced airway ventilation (AAV) may yield advantages over bag-mask ventilation (BMV) in the overall rate of ROSC in cardiopulmonary arrest (CPA) patients, but both approaches for airway management in this study resulted in a comparably favorable neurological outcome. Earlier return of spontaneous circulation (ROSC) would be required for improved overall outcome.Methods
- The study used the database of patients who suffered out-of-hospital cardiogenic CPA from 2006 to 2007 in the hospital.
- Patient records were searched for the method of pre-hospital airway management (BMV or AAV) and the patient’s outcomes were compared between groups.
- The primary endpoint was a favorable neurological outcome; the secondary endpoints were rate of return of spontaneous circulation (ROSC) and rate of admission to the intensive care unit (ICU).
- A total of 355 CPA patients (156 BMV and 199 AAV) were retrospectively enrolled.
- There was no significant difference in demographics between the two groups.
- The transportation time exceeded 30min in both groups.
- The overall ROSC rate and ICU admission rate were significantly higher in the AAV group (p=0.0352 and p=0.0089, respectively).
- The data showed that AAV (odds ratio 1.960; 95% confidence interval 1.015-3.785) resulted in a higher overall ROSC rate than BMV, but there were no significant differences in either the rate of pre-hospital ROSC or in favorable neurological outcome.