Effect of video laryngoscopy for non-trauma out-of-hospital cardiac arrest on clinical outcome: A registry-based analysis. (April 2023)

• Record Type: Journal Article
• Authors: Risse, Joachim; Fischer, Matthias; Meggiolaro, Karl Matteo; Fariq-Spiegel, Kaschoz; Pabst, Dirk; Manegold, Randi; Kill, Clemens; Fistera, David
• Is Part Of: Resuscitation. Volume 185(2023)
• Publication Date: 2023-04
• Subjects: Airway management -- Video laryngoscopy -- Cardiopulmonary resuscitation -- Endotracheal intubation -- Out-of-hospital cardiac arrest -- German Resuscitation Registry -- Multivariate logistic regression model; CPC cerebral performance category -- CPR cardiopulmonary resuscitation -- DL direct laryngoscopy -- EMS emergency medical services -- ETI endotracheal intubation -- GRR German Resuscitation Registry -- OHCA out-of-hospital cardiac arrest -- PES pre-emergency status -- ROSC return of spontaneous circulation -- SGA supraglottic airway -- VF ventricular fibrillation -- VL video laryngoscopy, VT, ventricular tachycardia; Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2023.109688
• Languages: English
• ISSNs: 0300-9572

Abstract

Abstract: Aim: Videolaryngoscopy (VL) is a promising tool to provide a safe airway during cardiopulmonary resuscitation (CPR) and to ensure early reoxygenation. Using data from the German Resuscitation Registry, we investigated the outcome of non-traumatic out-of-hospital cardiac arrest (OHCA) patients treated with VL versus direct laryngoscopy (DL) for airway management. Methods: We analysed retrospective data of 14, 387 patients from 1 January 2018 until 31 December 2021 (VL group, n = 2201; DL group, n = 12186). Primary endpoint was discharge with cerebral performance categories one and two (CPC1/2). Secondary endpoints were the rate of return of spontaneous circulation (ROSC), hospital admission, hospital admission with ongoing cardiopulmonary resuscitation, 30-day survival/ hospital discharge and airway management complications. We used multivariate binary logistic regression analysis to identify the effects on outcome of known influencing variables and of VL vs DL. Results: The multivariate regression model revealed that VL was an independent predictor of CPC1/2 survival (OR = 1.34, 95% CI = 1.12–1.61, p = 0.002) and of hospital discharge/30-day survival (OR = 1.26, 95% CI = 1.08–1.47, p = 0, 004). Conclusion: VL for endotracheal intubation (ETI) at OHCA was associated with better neurological outcome in patients with ROSC. Therefore, the use of VL for OHCA offers a promising perspective. Further prospective studies are required.