Pre-hospital Supraglottic Airway was Associated with Good Neurological Outcome in Cardiac Arrest Victims Especially Who Received Prolonged Cardiopulmonary Resuscitation

Abstract

Introduction

We performed this study to investigate the association of pre-hospital supraglottic airway (SGA) on neurological outcome in cardiac arrest victims with adjustment of post-resuscitation variables as well as pre-hospital and resuscitation variables.

Methods

This study was a retrospective study based on a multicenter prospective cohort registry from December 2013 to April 2016. According to the 28-day cerebral performance categories (CPC) scale, patients were divided into good outcome group (CPC 1–2) and poor outcome group (CPC 3–5). We compared the two groups with respect to demographic variables, pre-hospital and in-hospital resuscitation variables, and post-resuscitation variables.

Results

869 cardiac arrest victims who received in-progress cardiopulmonary resuscitation (CPR) were delivered to the emergency department of three hospitals, and 310 patients were admitted to the intensive care unit. The use of a pre-hospital SGA was independently associated with 28-day good neurological outcome [odds ratio (OR), 7.880; 95% confidence interval (CI), 1.334-46.534; p = 0.023] when post-resuscitation variables were adjusted, although there were no significant association with the acquisition of sustained return of spontaneous circulation (ROSC) [OR, 0.992; 95% CI, 0.591-1.666; p = 0.976]. Furthermore, a pre-hospital SGA was significantly associated with good neurological outcome, especially in patients who received prolonged CPR (low flow time >15 minutes) [OR, 3.411; 95% CI, 1.232-9.449; p = 0.018] rather than in patients with non-prolonged CPR [OR, 4.500; 95% CI, 0.746-27.132; P = 0.101].

Conclusions

When post-resuscitation variables were adjusted, the pre-hospital SGA was independently associated with 28-day good neurological outcome in cardiac arrest victims.

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