Meta-analysis of the effects between endotracheal intubation and laryngeal mask airway for patients with out-of-hospital cardiac arrest

Abstract

To comprehensively evaluate the resuscitation effect of endotracheal intubation (ETI) ventilation and laryngeal mask airway (LMA) for out-of-hospital cardiac arrest (OHCA). Databases such as Cochrane Library, PubMed, Embase, Ebsco, Elsevier, OVID, Springer, Proquest, and China biomedical literature database (CBMdisc), CNKI, Wanfang database, Chinese Science and Technology Journal Full-text Database, VIP Chinese biomedical journal database were searched from the establishment of literature database to December 2017 to study the difference of effects between ETI and LMA for patients with OHCA. The effect determination indexes included the return of spontaneous circulation (ROSC) rate, 1-month survival and 1-month neurological recovery. After evaluation of the quality of included studies and extraction of the data, the software of RevMan 5.3 was used to analyze those outcomes. A total of 9 articles, including 7 English, 2 Chinese; 5 prospective studies and 4 retrospective studies were included. All of the literatures had high quality, and the Newcastle Ottawa scale (NOS) scored 7-9 points. The Meta-analysis showed that ETI was significantly more beneficial than LMA in improving the rate of ROSC [odds ratio (OR) = 1.51, 95% confidence interval (95%CI) = 1.42-1.62, Z = 12.35,P < 0.01], and 1-month survival (OR = 1.16, 95%CI = 1.06-1.26, Z = 3.41, P < 0.01), and there was no significant difference in 1-month neurological recovery (OR = 1.13, 95%CI = 0.96-1.32, Z = 1.49, P = 0.14). ETI has higher recovery success rate and survival rate than LMA for the rescue of OHCA adult patients, but the improvement of the nervous system is unclear.