The Effect of Successful Intubation on Patient Outcomes After Out-of-Hospital Cardiac Arrest in Taipei

被引：32

作者：

Chiang, Wen-Chu ^{[1
,3
]}

Hsieh, Ming-Ju ^{[1
]}

Chu, Hsin-Lan ^{[1
]}

Chen, Albert Y. ^{[4
]}

Wen, Shin-Yi ^{[4
]}

Yang, Wen-Shuo ^{[5
]}

Chien, Yu-Chun ^{[5
,6
]}

Wang, Yao-Cheng ^{[5
]}

Lee, Bin-Chou ^{[7
]}

Wang, Huei-Chih ^{[1
]}

Huang, Edward Pei-Chuan ^{[1
]}

Yang, Chih-Wei ^{[2
]}

Sun, Jen-Tang ^{[8
]}

Chong, Kah-Meng ^{[1
]}

Lin, Hao-Yang ^{[1
]}

Hsu, Shu-Hsien ^{[9
]}

Chen, Shey-Ying ^{[1
]}

Huei-Ming, Matthew ^{[1
,3
]}

机构：

[1] Natl Taiwan Univ Hosp, Dept Emergency Med, Taipei, Taiwan

[2] Natl Taiwan Univ Hosp, Dept Med Educ, Taipei, Taiwan

[3] Natl Taiwan Univ Hosp, Dept Emergency Med, Yunlin Branch, Taipei, Yunlin, Taiwan

[4] Natl Taiwan Univ, Civil Engn, Taipei, Taiwan

[5] Taipei City Fire Dept, Emergency Med Serv Ambulance Div, Taipei, Taiwan

[6] Taipei Med Univ, Sch Publ Hlth, Taipei, Taiwan

[7] Taipei City Hosp, Chung Shaw Branch, Taipei, Taiwan

[8] Far Eastern Mem Hosp, Dept Emergency Med, New Taipei, Taiwan

[9] Natl Taiwan Univ Hosp, Hsinchu Branch, Dept Emergency Med, Hsinchu, Taiwan

来源：

ANNALS OF EMERGENCY MEDICINE | 2018年 / 71卷 / 03期

关键词：

ADVANCED AIRWAY MANAGEMENT; ENDOTRACHEAL INTUBATION; PARAMEDIC INTUBATION; RESUSCITATION; SURVIVAL; ASSOCIATION; TERMINATION; PERFORMANCE; GUIDELINES; PLACEMENT;

D O I：

10.1016/j.annemergmed.2017.08.008

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: The effect of out-of-hospital intubation in patients with out-of-hospital cardiac arrest remains controversial. The Taipei City paramedics are the earliest authorized to perform out-of-hospital intubation among Asian areas. This study evaluates the association between successful intubation and out-of-hospital cardiac arrest survival in Taipei. Methods: We analyzed 6 years of Utstein-based registry data from nontrauma adult patients with out-of-hospital cardiac arrest who underwent out-of-hospital airway management including intubation, laryngeal mask airway, or bag-valve mask ventilation. The primary analysis was intubation success on patient outcomes. The primary outcome was survival to discharge and the secondary outcomes included sustained return of spontaneous circulation and favorable neurologic survival. Sensitivity analysis was performed with intubation attempts rather than intubation success. Subgroup analysis of advanced life support-serviced districts was also performed. Results: A total of 10,853 cases from 2008 to 2013 were analyzed. Among out-of-hospital cardiac arrest patients receiving airway management, successful intubation, laryngeal mask airway, and bag-valve-mask ventilation was reported in 1,541, 3,099, and 6,213 cases, respectively. Compared with bag-valve-mask device use, successful out-of-hospital intubation was associated with improved chances of sustained return of spontaneous circulation (adjusted odds ratio [aOR] 1.91; 95% confidence interval [CI] 1.66 to 2.19), survival to discharge (aOR 1.98; 95% CI 1.57 to 2.49), and favorable neurologic outcome (aOR 1.44; 95% CI 1.03 to 2.03). The results were comparable in sensitivity and subgroup analyses. Conclusion: In nontrauma adult out-of-hospital cardiac arrest in Taipei, successful out-of-hospital intubation was associated with improved odds of sustained return of spontaneous circulation, survival to discharge, and favorable neurologic outcome.

引用

页码：387 / 396

页数：10

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