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Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction
OBJECTIVES: Several studies have examined the association between advanced airway management (AAM) and survival for arrest that is non-shockable, noncardiac in origin, or due to suffocation; however, the efficacy of prehospital AAM compared with no AAM following foreign body removal by emergency med...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244501/ https://www.ncbi.nlm.nih.gov/pubmed/34223396 http://dx.doi.org/10.1016/j.resplu.2021.100140 |
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author | Otomune, Kanako Hifumi, Toru Jinno, Keisuke Nakamura, Kentaro Okazaki, Tomoya Inoue, Akihiko Kawakita, Kenya Kuroda, Yasuhiro |
author_facet | Otomune, Kanako Hifumi, Toru Jinno, Keisuke Nakamura, Kentaro Okazaki, Tomoya Inoue, Akihiko Kawakita, Kenya Kuroda, Yasuhiro |
author_sort | Otomune, Kanako |
collection | PubMed |
description | OBJECTIVES: Several studies have examined the association between advanced airway management (AAM) and survival for arrest that is non-shockable, noncardiac in origin, or due to suffocation; however, the efficacy of prehospital AAM compared with no AAM following foreign body removal by emergency medical services (EMS) has not been examined. We aimed to compare neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA) due to foreign body airway obstruction (FBAO) managed with and without AAM after foreign body removal. METHODS: This retrospective observational cohort study used all emergency transportation data of Japan and the All-Japan Utstein Registry. We included patients with OHCA aged ≥18 years undergoing resuscitation and removal of airway foreign bodies by EMS from January 2015 to December 2017. The exposure of interest was prehospital AAM by EMS after foreign body removal, and the primary outcome was a favorable neurological outcome at hospital discharge (i.e., a cerebral performance category of 1–2). RESULTS: Overall, 329,098 adults had OHCAs and 23,060 had foreign bodies removed from their airways; 3681 adult patients met our eligibility criteria and were divided as: AAM (2045) and non-AAM (1636) groups. Propensity score matching resulted in 1210 matched pairs with balanced baseline characteristics between the groups. The rate of favorable neurological outcome was significantly lower in the AAM group than in the non-AAM group (OR 0.34, 95% CI 0.19–0.62). However, survival was not significantly different between the two groups (OR 1.08, 95% CI 0.84–1.37). CONCLUSIONS: We have not demonstrated the benefit of AAM for patients with OHCA due to FBAO. Further study will be required to confirm the efficacy of AAM for those patients. |
format | Online Article Text |
id | pubmed-8244501 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-82445012021-07-02 Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction Otomune, Kanako Hifumi, Toru Jinno, Keisuke Nakamura, Kentaro Okazaki, Tomoya Inoue, Akihiko Kawakita, Kenya Kuroda, Yasuhiro Resusc Plus Clinical Paper OBJECTIVES: Several studies have examined the association between advanced airway management (AAM) and survival for arrest that is non-shockable, noncardiac in origin, or due to suffocation; however, the efficacy of prehospital AAM compared with no AAM following foreign body removal by emergency medical services (EMS) has not been examined. We aimed to compare neurological outcomes in patients after out-of-hospital cardiac arrest (OHCA) due to foreign body airway obstruction (FBAO) managed with and without AAM after foreign body removal. METHODS: This retrospective observational cohort study used all emergency transportation data of Japan and the All-Japan Utstein Registry. We included patients with OHCA aged ≥18 years undergoing resuscitation and removal of airway foreign bodies by EMS from January 2015 to December 2017. The exposure of interest was prehospital AAM by EMS after foreign body removal, and the primary outcome was a favorable neurological outcome at hospital discharge (i.e., a cerebral performance category of 1–2). RESULTS: Overall, 329,098 adults had OHCAs and 23,060 had foreign bodies removed from their airways; 3681 adult patients met our eligibility criteria and were divided as: AAM (2045) and non-AAM (1636) groups. Propensity score matching resulted in 1210 matched pairs with balanced baseline characteristics between the groups. The rate of favorable neurological outcome was significantly lower in the AAM group than in the non-AAM group (OR 0.34, 95% CI 0.19–0.62). However, survival was not significantly different between the two groups (OR 1.08, 95% CI 0.84–1.37). CONCLUSIONS: We have not demonstrated the benefit of AAM for patients with OHCA due to FBAO. Further study will be required to confirm the efficacy of AAM for those patients. Elsevier 2021-05-27 /pmc/articles/PMC8244501/ /pubmed/34223396 http://dx.doi.org/10.1016/j.resplu.2021.100140 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Clinical Paper Otomune, Kanako Hifumi, Toru Jinno, Keisuke Nakamura, Kentaro Okazaki, Tomoya Inoue, Akihiko Kawakita, Kenya Kuroda, Yasuhiro Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction |
title | Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction |
title_full | Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction |
title_fullStr | Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction |
title_full_unstemmed | Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction |
title_short | Neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction |
title_sort | neurological outcomes associated with prehospital advanced airway management in patients with out-of-hospital cardiac arrest due to foreign body airway obstruction |
topic | Clinical Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8244501/ https://www.ncbi.nlm.nih.gov/pubmed/34223396 http://dx.doi.org/10.1016/j.resplu.2021.100140 |
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