Cardiac arrest & resuscitation
Advanced Airway Devices and End-Tidal Capnography Trends in Cardiac Arrest: A Secondary Analysis of a Randomized Clinical Trial
Authors' conclusion
In this secondary analysis of PART, EtCO2 values did not differ between LT and ETI.
Study context
- Population
- Adults (≥18 years) with nontraumatic out-of-hospital cardiac arrest (OHCA) from 27 emergency medical services (EMS) agencies (13 clusters), with ≥50% interpretable EtCO2 signalof 3004 PART cases
- Participants
- 1,113 adults
- Comparison
- Laryngeal tube (LT) vs endotracheal intubation (ETI) airway management
- LTn = 818
- ETIn = 295reference
- Primary endpoint
- Mean maximal EtCO2 values within 1-minute epochs and trends over resuscitation
Methodological detailsmulticentre, cluster-crossover
- Multicentre
- Cluster-crossover
Primary result
As reported in the abstract
EtCO2
- EtCO2 values did not differ between LT and ETI
- LT vs ETI: P = 0.07
- LT vs ETI: P = 0.89
- LT vs ETI: P = 0.28
Further findings
Sustained ROSC
EtCO2 trend × advanced airway interaction and outcomes
| Estimate | ||
|---|---|---|
| EtCO2 trend × airway interactionInteraction | OR for ROSC 1.75 (95% CI 1.25–2.45) | |
| EtCO2 trend × airway interactionNot associated with survival · interaction | OR for survival 1.21 (95% CI 0.90–1.61) | |
| 0.512Ratio (log scale) |
Return of spontaneous circulation (ROSC), airway-stratified analysis (subgroup)
| OR for ROSC (EtCO2 trend) (95% CI) | ||
|---|---|---|
| ETI | 2.34 (1.67–3.26) | |
| 0.20.5125OR for ROSC (EtCO2 trend) (log scale) |
| Outcome | OR for ROSC (EtCO2 trend) (95% CI) | |
|---|---|---|
| ROSC, airway-stratified analysis (subgroup)LT vs ETI | 1.33 (1.20–1.47) | |
| 0.512OR for ROSC (EtCO2 trend) (log scale) |
EtCO2 trend in ROSC vs non-ROSC cases
- LT: ROSC 27.9 to 52.3 mm Hg vs non-ROSC 32.6 to 23.5 mm Hg; increasing EtCO2 in ROSC
- P < 0.001
- ETI: ROSC 38.2 to 46.7 mm Hg vs non-ROSC 27.7 to 20.0 mm Hg; increasing EtCO2 in ROSC
- P < 0.001
Original publication
Advanced Airway Devices and End-Tidal Capnography Trends in Cardiac Arrest: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open. Published 2 September 2025. doi:10.
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