Endotracheal Intubation Versus Supraglottic Airway for Airway Management in Adults with Out-of-hospital Cardiac Arrest: A Systematic Review and Meta-analysis
Eurasian Journal of Emergency Medicine · 2024-06-28 · Meta-analysis
Abstract
Aim: The goal of this meta-analysis is to evaluate and compare the effectiveness of endotracheal intubation (ETI) and supraglottic airway (SGA) devices in airway management during out-of-hospital cardiac arrest events. Materials and Methods:Study was designed as a systematic review and meta-analysis and was conducted according to the 2020 PRISMA guidelines.Relevant studies published up to January 2024 were searched systematically using the following databases: PubMed, EMBASE, Scopus, Web of Science, and Cochrane Library.Pooled effect sizes were calculated using a random-effects model and reported as the odds ratios and 95% confidence intervals.Results: Out of 4218 records initially identified, 25 eligible studies were selected for inclusion in a meta-analysis.Survival to hospital admission was 26.8% for ETI and 14.5% for SGA (p<0.001).Survival rates among patients treated with ETI vs. SGA varied and amounted to: 25.5% vs. 17.6% for 24-h survival rate (p<0.001);13.4% vs. 15.1% (p=0.002); and 8.6% vs. 6.0%for survival to hospital discharge/30-d survival (p=0.09).Survival with favorable neurological outcomes occurs in 5.3% in ETI group, compared to 3.8% in SGA group (p=0.35).Conclusion: Our analysis reveals the nuanced and context-dependent nature of airway management in prehospital emergency care.The high heterogeneity across studies suggests that factors such as provider experience, patient characteristics, and the specific emergency context significantly influence outcomes.
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Tags
Endotracheal intubation · Mortality & survival · Quality of life & function · Supraglottic airway
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