Supraglottic Airway Versus Tracheal Intubation for Airway Management in Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials
Pooled result · ROSCResult — go to the resultRR for ROSC 1.09 95% CI 1.02–1.15Authors' conclusion
In adult patients with OHCA, compared with tracheal intubation, the use of SGA for initial airway management probably leads to more ROSC, and faster time to airway placement, but may have no effect on longer-term survival outcomes or aspiration events.
Study context
- Population
- Adults with out-of-hospital cardiac arrest (OHCA)
- Participants
- 13,412 adults · 4 randomized controlled trials (RCTs)
- Comparison
- SGA vs tracheal intubation for initial prehospital airway management
- Outcome
- ROSC
Methodological detailstrial sequential analysis, random-effects model, GRADE certainty assessment
- Trial sequential analysis
- Random-effects model
- GRADE certainty assessment
Pooled result
As reported in the abstract
RR for return of spontaneous circulation (ROSC)
1.09
95% CI 1.02–1.15
SGA vs Tracheal intubation
RR for ROSC 1.09 (95% CI 1.02–1.15)
Further pooled results
| Outcome | Mean difference (min less) (95% CI) | |
|---|---|---|
| Time to airway placementHigh certainty | 2.5 (1.6–3.4) | |
| −2024Difference, min less (linear scale) |
| Outcome | Estimate | |
|---|---|---|
| Survival at longest follow-upLow certainty | RR for survival 1.06 (95% CI 0.84–1.34) | |
| Survival with good functional outcomeVery low certainty | RR for survival with good functional outcome 1.11 (95% CI 0.82–1.50) | |
| AspirationLow certainty | RR for aspiration 1.04 (95% CI 0.94–1.16) | |
| 0.512Ratio (log scale) |
Safety
| Outcome | RR (95% CI) | |
|---|---|---|
| AspirationLow certainty | 1.04 (0.94–1.16) | |
| 0.512Relative risk (log scale) |
Original publication
Supraglottic Airway Versus Tracheal Intubation for Airway Management in Out-of-Hospital Cardiac Arrest: A Systematic Review, Meta-Analysis, and Trial Sequential Analysis of Randomized Controlled Trials. Crit Care Med. Published 13 November 2023. doi:10.
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