| Association of Advanced Airway Management Strategies with 72-Hour Survival in Out-of-Hospital Cardiac Arrest: Video Laryngoscopy vs. Direct Laryngoscopy vs. Supraglottic Airways |
Min Woo Kim1,2,3
, Jeong Ho Park1,2,3
, Ki Jeong Hong1,2,3
, Kyoung Jun Song2,3,4
, Sang Do Shin1,2,3
|
1Laboratory of Emergency Medical Services, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
2Department of Emergency Medicine, Seoul National University College of Medicine and Hospital, Seoul, Korea
3Disaster Medicine Research Center, Seoul National University Medical Research Center, Seoul, Republic of Korea
4Department of Emergency Medicine, Seoul National University College of Medicine and Seoul National University Boramae Medical Center, Seoul, South Korea |
| Correspondence
Jeong Ho Park Tel: +82-2-2072-1800, Fax: +82-2-741-7855, Email: timthe@gmail.com |
|
Received: November 23, 2025. Revised: December 4, 2025. Accepted: December 5, 2025. Published online: December 19, 2025. |
|
|
| ABSTRACT |
Objective
We aimed to compare the 72-hour survival of the endotracheal intubation (ETI) with video laryngoscope (VL), ETI with direct laryngoscope (DL), and supraglottic airway (SGA) in out-of-hospital cardiac arrest (OHCA) patients in Korea.
Methods
This study included adult OHCA patients who received advanced airway management by designated response teams for severe disease, using a nationwide OHCA registry in South Korea from July 2019 to December 2021. The primary outcome was 72-hour survival, and secondary outcomes were survival to hospital discharge and good neurological recovery. Multivariable logistic regression was used, adjusted for confounders, to compare the outcomes among the three airway management methods.
Results
Among 77,629 OHCA cases, 10,857 were included. SGA was attempted in 9,379 cases, ETI with DL in 493 cases, and ETI with VL in 985 cases. The rates of any prehospital ROSC and 72-hour survival were 13.3% and 11.0% for SGA, 16.0% and 11.4% for ETI with DL, and 18.2% and 11.9% for ETI with VL. Compared to SGA, ETI with VL was significantly associated with 72-hour survival: adjusted odds ratio (OR) [95% confidence interval (CI)] 1.34 (1.06-1.70) for ETI with VL and 1.13 (0.81-1.56) for ETI with DL). There was no significant association between the type of AAM and survival to discharge or good neurological recovery.
Conclusion
In an emergency medical service system staffed by advanced emergency medical technician-level providers, ETI with VL might be associated with improved 72-hour survival compared to SGA. However, this short-term benefit did not extend to survival to hospital discharge. |
| Keywords:
Out-of-Hospital Cardiac Arrest; Outcome; Airway management; Emergency Medical Service |
|
|
|
PDF Links
Full text via DOI
Download Citation 
