title: Impact of laryngeal tube use on chest compression fraction during out-of-hospital cardiac arrest. A prospective alternate month study.
abstract: OBJECTIVE
  Supraglottic devices are thought to allow efficient ventilation and continuous chest compressions during cardiac arrest. Therefore, the use of supraglottic devices could increase the chest compression fraction (CCF), a critical determinant of patient survival. The aim of this study was to assess the CCF in out-of-hospital cardiac arrest (OHCA) patients ventilated with a supraglottic device.
  
  
  METHODS
  We conducted an open prospective multicenter study with temporal clusters. OHCA patients treated by emergency nurses received either intermittent chest compressions with bag-valve mask ventilations (30:2 rhythm; BVM group); or continuous chest compressions with asynchronous ventilations by laryngeal tube (LT group). The primary endpoint was the CCF assessed using an accelerometer connected to the defibrillator. We also investigated the ease of use of the laryngeal tube.
  
  
  RESULTS
  Eighty-two patients were included (41 in each group); 68% were male and the median age was 68 (54-80) years. Patients and cardiac arrest characteristics did not differ between groups. The CCF was 75% (68-79%) in the LT group and 59% (51-68%) in the BVM group (p<0.01). LT insertion failed in nine out of 40 cases (23%). The median time of LT insertion was 26s (11-56 s). CCF was significantly lower when LT insertion failed (58% (48-74%) vs. 76% (72-80%) when LT insertion succeeded; p=0.01).
  
  
  CONCLUSIONS
  The use of the LT during OHCA increases the CCF when compared to standard BVM ventilation. However, the impact of LT use on mortality remains unclear.
authors.affiliation: University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France; University Grenoble Alps, CNRS UMR 5525, TIMC-IMAG Laboratory, Team PRETA, Grenoble, France. Electronic address: mmaignan@chu-grenoble.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Maignan
authors.affiliation: University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France.
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Koch
authors.affiliation: University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Kraemer
authors.affiliation: University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Lehodey
authors.affiliation: University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France; INSERM U1042, HP2 Laboratory, University Grenoble Alps, Grenoble, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Viglino
authors.affiliation: Fire Department, SDIS 38, Fontaine, France.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Monnet
authors.affiliation: Fire Department, SDIS 38, Fontaine, France.
authors.forename: Dominique
authors.initials: D
authors.lastname: Pham
authors.affiliation: Fire Department, SDIS 38, Fontaine, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Roux
authors.affiliation: University Grenoble Alps - Center for Clinical Investigation, CHU Michallon, Grenoble, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Genty
authors.affiliation: University Grenoble Alps - Center for Clinical Investigation, CHU Michallon, Grenoble, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Rolland
authors.affiliation: University Grenoble Alps - Center for Clinical Investigation, CHU Michallon, Grenoble, France.
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Bosson
authors.affiliation: University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Danel
authors.affiliation: University Grenoble Alps - Emergency Department and Mobile Intensive Care Unit, CHU Michallon, Grenoble, France; University Grenoble Alps, CNRS UMR 5525, TIMC-IMAG Laboratory, Team PRETA, Grenoble, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Debaty
mesh_terms: D061725:Accelerometry / Q000379:methods; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000009:adverse effects / Q000379:methods; D047548:Defibrillators / Q000009:adverse effects; D019544:Equipment Failure Analysis; D004869:Equipment Safety; D005260:Female; D050723:Fractures, Bone / Q000209:etiology / Q000517:prevention & control; D005602:France; D006801:Humans; D007442:Intubation, Intratracheal / Q000295:instrumentation*; D008297:Male; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy*; D010043:Outcome and Process Assessment, Health Care
keywords: Cardiac arrest; Chest compression fraction; Laryngeal tube; Supraglottic airway device