Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial
Background: Advanced airway devices facilitate ventilation and oxygenation during out-of-hospital cardiac arrest (OHCA). Differences in gas exchange between advanced airway devices are unknown. Objective: Characterize arterial blood gases (ABG) in laryngeal tube (LT) or endotracheal intubation (ETI)...
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Elsevier
2025-09-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520425001559 |
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| author | Grace C. Sullivan Henry E. Wang Christopher B. Gage Jonathan R. Powell Elisabete Aramendi Xabier Jaureguibeitia Andoni Elola Ahamed Idris Mohamud R. Daya Shannon W. Stephens Jestin N. Carlson Graham Nichol Tom P. Aufderheide Ashish R. Panchal Michelle M.J. Nassal |
| author_facet | Grace C. Sullivan Henry E. Wang Christopher B. Gage Jonathan R. Powell Elisabete Aramendi Xabier Jaureguibeitia Andoni Elola Ahamed Idris Mohamud R. Daya Shannon W. Stephens Jestin N. Carlson Graham Nichol Tom P. Aufderheide Ashish R. Panchal Michelle M.J. Nassal |
| author_sort | Grace C. Sullivan |
| collection | DOAJ |
| description | Background: Advanced airway devices facilitate ventilation and oxygenation during out-of-hospital cardiac arrest (OHCA). Differences in gas exchange between advanced airway devices are unknown. Objective: Characterize arterial blood gases (ABG) in laryngeal tube (LT) or endotracheal intubation (ETI) cases in the Pragmatic Airway Resuscitation Trial (PART). Methods: We included adult OHCAs with ABG collected ≤ 1.5 h after emergency department (ED) arrival. We collected 1) last prehospital airway technique used 2) ABG measurements (pH, PaO2, PaCO2), and 3) average prehospital end-tidal capnography (EtCO2) values for the last five minutes. We compared airway types, ABG values, and PaCO2-EtCO2 absolute difference (PaCO2-EtCO2) using the Mann-Whitney test, stratifying by circulation status. We also determined prehospital EtCO2 and ED PaCO2 correlation. Results: Of 3004 cases, 401 met inclusion with 272 LT and 129 ETI. Among cases achieving return of spontaneous circulation (ROSC), pH (7.1 vs. 7.2, p = 0.10) and PaO2 (142 vs 170 mmHg, p = 0.08) did not differ. PaCO2 was higher in LT than ETI (58 vs 50 mmHg, p = 0.003). Among cases without ROSC, pH (7.0 vs. 7.0, p = 0.55) and PaCO2 (64 vs. 61 mmHg, p = 0.58) did not differ, but PaO2 was lower in LT than ETI (85 vs. 123 mmHg, p = 0.03). EtCO2 did not correlate with PaCO2 in any airway device/ROSC combination. PaCO2-EtCO2 difference was wider in both LT and ETI non-ROSC cases compared to ROSC cases (27 vs 18 mmHg, p = 0.03). Conclusions: ABG values may vary by prehospital advanced airway management methods. The correlation between EtCO2 and PaCO2 in OHCA patients remains unclear. |
| format | Article |
| id | doaj-art-5a24a621a87e42aa9bb7f22f15b4aa19 |
| institution | Matheson Library |
| issn | 2666-5204 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Resuscitation Plus |
| spelling | doaj-art-5a24a621a87e42aa9bb7f22f15b4aa192025-07-09T04:32:53ZengElsevierResuscitation Plus2666-52042025-09-0125101018Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trialGrace C. Sullivan0Henry E. Wang1Christopher B. Gage2Jonathan R. Powell3Elisabete Aramendi4Xabier Jaureguibeitia5Andoni Elola6Ahamed Idris7Mohamud R. Daya8Shannon W. Stephens9Jestin N. Carlson10Graham Nichol11Tom P. Aufderheide12Ashish R. Panchal13Michelle M.J. Nassal14College of Medicine, The Ohio State University, 1645 Neil Ave, Columbus, OH 43210, United StatesDepartment of Emergency Medicine, The Ohio State University, 376 W 10th Ave, 750 Prior Hall, Columbus OH 43210, United StatesNational Registry of EMTs, 6610 Busch Blvd, Suite 200, Columbus, OH 43229, United StatesDepartment of Emergency Medicine, The Ohio State University, 376 W 10th Ave, 750 Prior Hall, Columbus OH 43210, United StatesDepartment of Communication Engineering, BioRes Group, University of the Basque Country, Ingeniero Torres Quevedo Plaza, 1, 48013 Bilbao, Biscay, SpainDepartment of Communication Engineering, BioRes Group, University of the Basque Country, Ingeniero Torres Quevedo Plaza, 1, 48013 Bilbao, Biscay, SpainDepartment of Electronic Technology, BioRes Group, University of the Basque Country, Ingeniero Torres Quevedo Plaza, 1, 48013 Bilbao Biscay SpainDepartment of Emergency Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard E4.300, Dallas, TX 75390, United StatesDepartment of Emergency Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, United StatesDepartment of Surgery, The University of Alabama, 1808 7th Avenue South, Boshell Diabetes Building #505, Birmingham, AL 35233, United StatesDepartment of Emergency Medicine, University of Pittsburgh, 3600 Forbes Ave Iroquois Building, Suite 400A, Pittsburgh, PA 15213, United StatesDepartment of Emergency Medicine, University of Washington, 1705 NE Pacific Street, Magnuson Health Sciences Building F Wing, UW Box 357235, Seattle, WA 98195, United StatesDepartment of Emergency Medicine, Medical College of Wisconsin, 8701 Watertown Plank Rd, Hub for Collaborative Medicine, Milwaukee, WI 53226, United StatesDepartment of Emergency Medicine, The Ohio State University, 376 W 10th Ave, 750 Prior Hall, Columbus OH 43210, United StatesDepartment of Emergency Medicine, The Ohio State University, 376 W 10th Ave, 750 Prior Hall, Columbus OH 43210, United States; Corresponding author at: Department of Emergency Medicine, The Ohio State University, 376 W 10th Ave, 760B Prior Hall, Columbus, OH 43210, United States.Background: Advanced airway devices facilitate ventilation and oxygenation during out-of-hospital cardiac arrest (OHCA). Differences in gas exchange between advanced airway devices are unknown. Objective: Characterize arterial blood gases (ABG) in laryngeal tube (LT) or endotracheal intubation (ETI) cases in the Pragmatic Airway Resuscitation Trial (PART). Methods: We included adult OHCAs with ABG collected ≤ 1.5 h after emergency department (ED) arrival. We collected 1) last prehospital airway technique used 2) ABG measurements (pH, PaO2, PaCO2), and 3) average prehospital end-tidal capnography (EtCO2) values for the last five minutes. We compared airway types, ABG values, and PaCO2-EtCO2 absolute difference (PaCO2-EtCO2) using the Mann-Whitney test, stratifying by circulation status. We also determined prehospital EtCO2 and ED PaCO2 correlation. Results: Of 3004 cases, 401 met inclusion with 272 LT and 129 ETI. Among cases achieving return of spontaneous circulation (ROSC), pH (7.1 vs. 7.2, p = 0.10) and PaO2 (142 vs 170 mmHg, p = 0.08) did not differ. PaCO2 was higher in LT than ETI (58 vs 50 mmHg, p = 0.003). Among cases without ROSC, pH (7.0 vs. 7.0, p = 0.55) and PaCO2 (64 vs. 61 mmHg, p = 0.58) did not differ, but PaO2 was lower in LT than ETI (85 vs. 123 mmHg, p = 0.03). EtCO2 did not correlate with PaCO2 in any airway device/ROSC combination. PaCO2-EtCO2 difference was wider in both LT and ETI non-ROSC cases compared to ROSC cases (27 vs 18 mmHg, p = 0.03). Conclusions: ABG values may vary by prehospital advanced airway management methods. The correlation between EtCO2 and PaCO2 in OHCA patients remains unclear.http://www.sciencedirect.com/science/article/pii/S2666520425001559Cardiac arrestVentilationAdvanced airwayArterial blood gas |
| spellingShingle | Grace C. Sullivan Henry E. Wang Christopher B. Gage Jonathan R. Powell Elisabete Aramendi Xabier Jaureguibeitia Andoni Elola Ahamed Idris Mohamud R. Daya Shannon W. Stephens Jestin N. Carlson Graham Nichol Tom P. Aufderheide Ashish R. Panchal Michelle M.J. Nassal Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial Resuscitation Plus Cardiac arrest Ventilation Advanced airway Arterial blood gas |
| title | Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial |
| title_full | Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial |
| title_fullStr | Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial |
| title_full_unstemmed | Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial |
| title_short | Effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial |
| title_sort | effect of prehospital advanced airway management on arterial blood gases in the pragmatic airway resuscitation trial |
| topic | Cardiac arrest Ventilation Advanced airway Arterial blood gas |
| url | http://www.sciencedirect.com/science/article/pii/S2666520425001559 |
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