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Airway Management Training Might Improve Return Of Spontaneous Circulation Rate in Out-of-Hospital Cardiac Arrest Using Supraglottic Airways vs. Endotracheal Intubation: A Systematic Review and Meta-Analysis
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DOI：10.1016/j.jemermed.2026.01.017.png)
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Abstract
En 中文
Background: The optimal airway management strategy in out-of-hospital cardiac arrest has been controversial. Whereas endotracheal intubation currently represents the gold standard, supraglottic airway securement may provide advantages with respect to handling out-of-hospital cardiac arrest. Objectives: This meta-analysis of randomized controlled and clinical studies evaluates the effects of the advanced airway strategy (supraglottic vs. endotracheal intubation) on return of spontaneous circulation (ROSC). Methods: This systematic review and meta-analysis was performed based on a predefined protocol. Literature search included PubMed, Web of Science, and the Cochrane Library. Results: A total of eight clinical studies including 14,797 patients were analyzed. Pooled analysis indicated no higher rate of ROSC in patients treated with supraglottic airway vs. endotracheal intubation (risk difference [RD] 0.02, 95% confidence interval [CI] 0.0-0.04, p = 0.11) and no higher rate of survival to hospital discharge (RD 0.01, 95% CI-0.01-0.02, p = 0.30). Interestingly, additional training indicated a significant effect of supraglottic airway on ROSC, whereas the subgroup difference was not significant (RD [additional training] 0.02, 95% CI 0.0-0.04, p = 0.02, RD [no additional training] 0.01, 95% CI-0.05-0.01, p = 0.72, test for subgroup differences, p = 0.73). Training programs differed between the investigated studies. Statistical hetero geneity was not observed. Conclusion: Overall, the type of advanced airway (supraglottic vs. endotracheal intubation) did not impact ROSC or survival to hospital discharge. However, after additional training, supraglottic airway use may have a positive effect on ROSC in out-of-hospital cardiac arrest. (c) 2026 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/)
Keywords:
Supraglottic
Endotracheal
OHCA
ROSC
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