The effect of airway management on CPR quality in the PARAMEDIC2 randomised controlled trial
The effect of airway management on CPR quality in the PARAMEDIC2 randomised controlled trial
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.
Adrenaline, Advanced life support, Airway, Cardiac arrest, Compression fraction, Epinephrine, Outcome
8-13
Deakin, Charles D.
560d993b-bbc9-4548-9990-272ed18a011d
Nolan, Jerry P.
89ed703a-50bd-4b8e-88cb-fc6e9d1245b1
Ji, Chen
ec0e8792-9309-4071-8517-e94966a81cf6
Fothergill, Rachael T.
42fb438d-876d-4bd5-8110-4de8378de764
Quinn, Tom
6be2aa1d-fc2f-4610-b8d0-4f85a74828ed
Rosser, Andy
cffd69df-82bb-4a53-9088-60a4deeaba86
Lall, Ranjit
2dd7769c-3fa4-43f5-942d-188f67c2bddd
Perkins, Gavin D.
62ab34e9-3022-4b9d-a64b-99a13fbe45a3
Deakin, Charles D.
560d993b-bbc9-4548-9990-272ed18a011d
Nolan, Jerry P.
89ed703a-50bd-4b8e-88cb-fc6e9d1245b1
Ji, Chen
ec0e8792-9309-4071-8517-e94966a81cf6
Fothergill, Rachael T.
42fb438d-876d-4bd5-8110-4de8378de764
Quinn, Tom
6be2aa1d-fc2f-4610-b8d0-4f85a74828ed
Rosser, Andy
cffd69df-82bb-4a53-9088-60a4deeaba86
Lall, Ranjit
2dd7769c-3fa4-43f5-942d-188f67c2bddd
Perkins, Gavin D.
62ab34e9-3022-4b9d-a64b-99a13fbe45a3
Deakin, Charles D., Nolan, Jerry P., Ji, Chen, Fothergill, Rachael T., Quinn, Tom, Rosser, Andy, Lall, Ranjit and Perkins, Gavin D.
(2020)
The effect of airway management on CPR quality in the PARAMEDIC2 randomised controlled trial.
Resuscitation, 158, .
(doi:10.1016/j.resuscitation.2020.11.005).
Abstract
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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More information
Accepted/In Press date: 2 November 2020
e-pub ahead of print date: 12 November 2020
Additional Information:
Funding Information:
The trial was funded by the Health Technology Assessment Programme of the National Institute for Health Research (NIHR) and supported by NIHR Applied Research Centre (ARC) West Midlands, UK, NIHR Comprehensive Research Network, Out-of-Hospital Cardiac Arrest Registry, which is funded by the British Heart Foundation and Resuscitation Council UK ; and by Health Care Wales .
Funding Information:
The trial was funded by the Health Technology Assessment Programme of the National Institute for Health Research (NIHR) and supported by NIHR Applied Research Centre (ARC) West Midlands, UK, NIHR Comprehensive Research Network, Out-of-Hospital Cardiac Arrest Registry, which is funded by the British Heart Foundation and Resuscitation Council UK; and by Health Care Wales.
Publisher Copyright:
© 2020
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Adrenaline, Advanced life support, Airway, Cardiac arrest, Compression fraction, Epinephrine, Outcome
Identifiers
Local EPrints ID: 450418
URI: http://eprints.soton.ac.uk/id/eprint/450418
ISSN: 0300-9572
PURE UUID: 261d55e0-8968-4790-bec7-908dc12f5f32
Catalogue record
Date deposited: 27 Jul 2021 17:26
Last modified: 17 Mar 2024 12:47
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Contributors
Author:
Jerry P. Nolan
Author:
Chen Ji
Author:
Rachael T. Fothergill
Author:
Tom Quinn
Author:
Andy Rosser
Author:
Ranjit Lall
Author:
Gavin D. Perkins
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