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@article{Benger:2018:10.1001/jama.2018.11597,
author = {Benger, JR and Kirby, K and Black, S and Brett, SJ and Clout, M and Lazaroo, MJ and Nolan, JP and Reeves, BC and Robinson, M and Scott, LJ and Smartt, H and South, A and Stokes, EA and Taylor, J and Thomas, M and Voss, S and Wordsworth, S and Rogers, CA},
doi = {10.1001/jama.2018.11597},
journal = {Journal of the American Medical Association},
pages = {779--791},
title = {Effect of a strategy of supraglottic airway device versus tracheal intubation 4 during out-of-hospital cardiac arrest on functional outcome: the AIRWAYS-2 5 randomized clinical trial},
url = {http://dx.doi.org/10.1001/jama.2018.11597},
volume = {320},
year = {2018}
}

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TY  - JOUR
AB  - Importance  The optimal approach to airway management during out-of-hospital cardiac arrest is unknown.Objective  To determine whether a supraglottic airway device (SGA) is superior to tracheal intubation (TI) as the initial advanced airway management strategy in adults with nontraumatic out-of-hospital cardiac arrest.Design, Setting, and Participants  Multicenter, cluster randomized clinical trial of paramedics from 4 ambulance services in England responding to emergencies for approximately 21 million people. Patients aged 18 years or older who had a nontraumatic out-of-hospital cardiac arrest and were treated by a participating paramedic were enrolled automatically under a waiver of consent between June 2015 and August 2017; follow-up ended in February 2018.Interventions  Paramedics were randomized 1:1 to use TI (764 paramedics) or SGA (759 paramedics) as their initial advanced airway management strategy.Main Outcomes and Measures  The primary outcome was modified Rankin Scale score at hospital discharge or 30 days after out-of-hospital cardiac arrest, whichever occurred sooner. Modified Rankin Scale score was divided into 2 ranges: 0-3 (good outcome) or 4-6 (poor outcome; 6 = death). Secondary outcomes included ventilation success, regurgitation, and aspiration.Results  A total of 9296 patients (4886 in the SGA group and 4410 in the TI group) were enrolled (median age, 73 years; 3373 were women [36.3%]), and the modified Rankin Scale score was known for 9289 patients. In the SGA group, 311 of 4882 patients (6.4%) had a good outcome (modified Rankin Scale score range, 0-3) vs 300 of 4407 patients (6.8%) in the TI group (adjusted risk difference [RD], −0.6% [95% CI, −1.6% to 0.4%]). Initial ventilation was successful in 4255 of 4868 patients (87.4%) in the SGA group compared with 3473 of 4397 patients (79.0%) in the TI group (adjusted RD, 8.3% [95% CI, 6.3% to 10.2%]). However, patients randomized to receive TI were less likely to receive
AU  - Benger,JR
AU  - Kirby,K
AU  - Black,S
AU  - Brett,SJ
AU  - Clout,M
AU  - Lazaroo,MJ
AU  - Nolan,JP
AU  - Reeves,BC
AU  - Robinson,M
AU  - Scott,LJ
AU  - Smartt,H
AU  - South,A
AU  - Stokes,EA
AU  - Taylor,J
AU  - Thomas,M
AU  - Voss,S
AU  - Wordsworth,S
AU  - Rogers,CA
DO  - 10.1001/jama.2018.11597
EP  - 791
PY  - 2018///
SN  - 0098-7484
SP  - 779
TI  - Effect of a strategy of supraglottic airway device versus tracheal intubation 4 during out-of-hospital cardiac arrest on functional outcome: the AIRWAYS-2 5 randomized clinical trial
T2  - Journal of the American Medical Association
UR  - http://dx.doi.org/10.1001/jama.2018.11597
VL  - 320
ER  -

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