Minerva Anestesiologica 2020 Dec 10

DOI: 10.23736/S0375-9393.20.14446-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Performance of the laryngeal tube for airway management during cardiopulmonary resuscitation: a systematic review and meta-analysis

Jochen HINKELBEIN ¹ ✉, Jan SCHMITZ ¹, Alexander MATHES ¹, Edoardo DE ROBERTIS ²

¹ Department for Anaesthesiology and Intensive Care Medicine, University Hospital of Cologne, Cologne, Germany; ² Department of Surgical and Biomedical Sciences, Division of Anaesthesia, Analgesia, and Intensive Care, University of Perugia, Perugia, Italy

BACKGROUND: Sudden cardiac arrest is one of the leading causes of death in Europe and the whole world. Effective chest compressions and advanced airway management have been shown to improve survival rates. Supraglottic airway devices such as the laryngeal tube (LT) are a well-known strategy for patients with cardiac arrest during both Basic (BLS) and Advanced Life Support (ALS). This systematic literature review aims to summarize current data for using the LT when performing BLS and ALS.
METHODS: Recent data on the use of the LT during CPR was gathered by using the MEDLINE® database and a specific search strategy. Terms were used in various order and combinations without time restrictions. A total of N=1005 studies were identified and screened by two experienced anesthesiologists/emergency physicians independently. Altogether, data of n=19 relevant papers were identified and included in the analysis.
RESULTS: Using the LT showed fast and easy placement with high success rates (76% to 94%) and was associated with higher short-term survival as compared to other strategies for initial airway management (2.2% vs 1.4%). Quality of CPR such as Chest Compression Fraction (CCF) before and after LT-insertion is improved (75% vs 59%). For long-term survival, the LT showed lower survival rates.
CONCLUSIONS: Especially as initial device of airway management (for inexperienced staff), the use of a LT is easy and results in a fast insertion. The advantages of the LT as compared to bag mask ventilation and endotracheal intubation are inhomogeneous in recent literature.

KEY WORDS: Laryngeal Tube; CPR; Resuscitation; Airway management; Critical care