The effect of airway management on CPR quality in the PARAMEDIC2 randomised controlled trial

RESUSCITATION

卷:158

Article

Deakin, Charles D.^1,2  Nolan, Jerry P.^3,4  Ji, Chen³  Fothergill, Rachael T.^3,5,6  Quinn, Tom⁶  Rosser, Andy⁷  Lall, Ranjit³  Perkins, Gavin D.^3,8 

[1] South Cent Ambulance Serv NHS Fdn Trust, Otterbourne SO21 2RU, England

[2] NIHR Southampton Resp Biomed Res Unit, Southampton SO16 6YD, Hants, England

[3] Univ Warwick, Warwick Clin Trials Unit, Coventry CV4 7AL, W Midlands, England

[4] Royal United Hosp, Bath BA1 3NG, Avon, England

[5] London Ambulance Serv NHS Trust, 8-20 Pocock St, London SE1 0BW, England

[6] Univ London, Kingston Univ & St Georges, 6th Floor,Hunter Wing, London SW17 0RE, England

[7] West Midlands Ambulance Serv Univ NHS Fdn Trust, Brierley Hill, West Midlands DY5 1LX, England

[8] Univ Hosp Birmingham, Heartlands Hosp, Birmingham B9 5SS, W Midlands, England

关键词: Advanced life support;    Adrenaline;    Epinephrine;    Cardiac arrest;    Airway;    Compression fraction;    Outcome;   

DOI  :  10.1016/j.resuscitation.2020.11.005

来源: Elsevier

【 摘 要 】

Introduction: Good quality basic life support (BLS) is associated with improved outcome from cardiac arrest. Chest compression fraction (CCF) is a BLS quality indicator, which may be influenced by the type of airway used. We aimed to assess CCF according to the airway strategy in the PARAMEDIC2 study: no advanced airway, supraglottic airway (SGA), tracheal intubation, or a combination of the two. Our hypothesis was that tracheal intubation was associated with a decrease in the CCF compared with alternative airway management strategies. Methods: PARAMEDIC2 was a multicentre double-blinded placebo-controlled trial of adrenaline vs placebo in out-of-hospital cardiac arrest. Data showing compression rate and ratio from patients recruited by London Ambulance Service (LAS) as part of this study was collated and analysed according to the advanced airway used during the resuscitation attempt. Results: CPR process data were available from 286/2058 (13.9%) of the total patients recruited by LAS. The mean compression rate for the first 5 min of data recording was the same in all groups (P = 0.272) and ranged from 104.2 (95% CI of mean: 100.5, 107.8) min(-1) to 108.0 (95% CI of mean: 105.1, 108.3) min(-1). The mean compression fraction was also similar across all groups (P = 0.159) and ranged between 74.7% and 78.4%. There was no difference in the compression rates and fractions across the airway management groups, regardless of the duration of CPR. Conclusion: There was no significant difference in the compression fraction associated with the airway management strategy.

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