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Published on: January 30, 2020
COMPARISON OF DIFFERENT OUT-OF-HOSPITAL AIRWAY MANAGEMENT TECHNIQUES IN PATIENTS WITH CARDIAC ARREST IN SLAVONIA
Ivo Matić1, Ivana Pajić Matić1, Marcel Marcikić1
11Department of Anesthesiology, Resuscitation and Intensive Care, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Ear, Head and Neck Surgery, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Department for Neurosurgery, Dr. Josip Benčević General Hospital, Slavonski Brod, Croatia.
Abstract:
Endotracheal intubation is the gold standard in inpatient treatment of cardiac arrest patients; however, there are conflicting research results in out-of-hospital conditions. This prospective study included 92 patients with confirmed cardiac arrest occurring outside a hospital facility, who fulfilled the inclusion criteria and whom the emergency ambulance team reached within 20 minutes from the event. Medical data on each patient (age, gender, cause of arrest, estimated time of arrest, time to arrival of the ambulance team, resuscitation commenced prior to arrival of the ambulance team, initial electrocardiographic rhythm, method of airway management, and success of resuscitation) were recorded. The airway maintenance techniques applied in the patients were endotracheal intubation and I-gel laryngeal mask (LMA). The rate of spontaneous circulation recovery resulting from different techniques of airway management and the incidence of spontaneous circulation recovery between the defibrillation rhythm and non-defibrillable rhythm groups were recorded for each patient. Forty-seven patients received endotracheal tube and the rest of 45 patients I-gel LMA treatment. The ratio of achieving spontaneous circulation with intubation versus I-gel LMA was 13 (28%) to 11 (24%) (p=0.725). The best return of spontaneous circulation results was recorded in patients suffering from ventricular fibrillation; however, there was no statistically significant difference between the intubation and I-gel LMA treatments (8 (47%) vs. 7 (41%); p=0.916). No statistically significant difference was observed between the outcomes of patients resuscitated by endotracheal intubation and I-gel LMA methods either.
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Tracheostomy Decannulation
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...

