Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Otomune, Kanako, Hifumi, Toru, Jinno, Keisuke, Nakamura, Kentaro, Okazaki, Tomoya, Inoue, Akihiko, Kawakita, Kenya, Kuroda, Yasuhiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
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
_version_ 1783715947822972928
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
work_keys_str_mv AT otomunekanako neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction
AT hifumitoru neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction
AT jinnokeisuke neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction
AT nakamurakentaro neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction
AT okazakitomoya neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction
AT inoueakihiko neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction
AT kawakitakenya neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction
AT kurodayasuhiro neurologicaloutcomesassociatedwithprehospitaladvancedairwaymanagementinpatientswithoutofhospitalcardiacarrestduetoforeignbodyairwayobstruction