Intubation in cardiac arrest: the ROC of our salvation?

The Resuscitation Outcomes Consortium (ROC) is a North American clinical trials research network focussing on out-of-hospital cardiac arrest (OHCA) and traumatic injury. In this study, Wang and colleagues performed a secondary analysis of clinical data collected prospectively as part of an earlier trial (ROC PRIMED, 2011).

The authors sought to determine survival to discharge with satisfactory functional status in adult (≥ 18 years) cases of non-traumatic cardiac arrest managed with endotracheal intubation (ETI) vs insertion of a supraglottic airway (SGA). Secondary outcomes included 24-hour survival, return of spontaneous circulation (ROSC) and presence of airway and pulmonary complications (pulmonary oedema, internal thoracic or abdominal injuries, acute lung injury, sepsis and pneumonia).

Patients who did not require advanced airway insertion or in whom these efforts failed were excluded from the analysis. In addition, data from King County and Seattle emergency medical services (EMS) were excluded as these agencies were not using SGA devices at the time of the initial study. Patients receiving both ETI and SGA insertion were classified as SGA cases.