Newer Breathing Tube Might Save More Cardiac Arrest Patients

WEDNESDAY, Aug. 29, 2018 — Changing the type of breathing tube that first responders use to resuscitate cardiac arrest patients can boost the chances of survival, a new study contends.

There are about 400,000 out-of-hospital cardiac arrests in the United States each year. More than 90 percent of those patients die before, or soon after, they reach the hospital.

Cardiac arrest occurs when the heart suddenly stops beating, cutting off blood flow to the brain and other vital organs.

The standard resuscitation technique used by emergency medical service (EMS) providers has been insertion of a plastic tube into the trachea, known as endotracheal intubation, to maintain an open airway. This is meant to mirror the care given in hospitals.

But new devices such as laryngeal tubes provide an easier, simpler way to open an airway and improve survival rates, according to the study funded by the U.S. National Heart, Lung, and Blood Institute (NHLBI).

“While identical to techniques used by doctors in the hospital, intubation in these severe and stressful prehospital settings is very difficult and fraught with errors,” explained study lead author Dr. Henry Wang. He’s vice chair for research with the University of Texas Health Science Center’s department of emergency medicine.

Study co-author Dr. George Sopko is program director in the division of cardiovascular sciences at the NHLBI. He noted that getting it right is critical.

“During resuscitation, opening the airway and having proper access to it is a key factor for the survival of someone who goes into cardiac arrest outside of a hospital,” Sopko said in an institute news release.

“But one of the burning questions in prehospital emergency care has been, ‘Which is the best airway device?’ ” he said.

“This study demonstrated that just by managing the airway well in the early stage of resuscitation, we could save more than 10,000 lives every year,” Sopko added.

The researchers compared survival rates among 3,000 adult cardiac arrest patients in five large U.S. cities. About half the patients received the newer laryngeal tube treatment, while the other half received traditional endotracheal intubation.

In the laryngeal tube group, 18.3 percent of patients survived three days in the hospital and 10.8 percent survived until being discharged from the hospital. The survival rates in the traditional endotracheal intubation group were 15.4 percent and 8.1 percent, respectively.

The researchers also found that rates of survival with good brain function were higher in the laryngeal tube group.

The findings were published online Aug. 28 in the Journal of the American Medical Association.

More information

The American Heart Association has more on cardiac arrest.

Posted: August 2018

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