Endotracheal Intubation Versus No Endotracheal Intubation During Cardiopulmonary Arrest in the Emergency Department

Abstract

Background There is a lack of studies addressing the short and long-term outcomes of using different airway interventions in patients with cardiopulmonary arrest in the emergency department (ED). This retrospective chart review aimed to investigate the effect of endotracheal intubation (ETI) versus no ETI during cardiopulmonary arrest in the ED on return of spontaneous circulation (ROSC) and survival to discharge. Methodology A total of 168 charts were reviewed from August 2017 to April 2019. Resuscitation characteristics were obtained from Utstein-style-based cardiopulmonary arrest flow sheets. Results Unadjusted analysis showed no difference in ROSC (45.5% in ETI vs. 54.5% in no-ETI) (p = 0.08) and survival to hospital discharge at 28 days (26.7% in ETI vs. 73.3% in non-ETI) (p = 0.07) when comparing ETI versus non-ETI airway management methods during cardiopulmonary resuscitation (CPR). After adjusting for confounding factors, our regression analysis revealed that the use of ETI is associated with lower odds of ROSC (odds ratio [OR] = 3.40, 95% confidence interval [CI] = [0.14-0.84]) and survival to hospital discharge at 28 days (OR = 0.20, 95% CI = [0.04-0.84]). Conclusions ETI during CPR in the ED is associated with worse ROSC and survival to hospital discharge at 28 days.