AIM To determine the type of airway devices used during in-hospital cardiac arrest (IHCA) resuscitation attempts. METHODS International multicentre retrospective observational study of in-patients aged over 18 years who received chest compressions for cardiac arrest from April 2016 to September 2018. Patients were identified from resuscitation registries and rapid response system databases. Data were collected through review of resuscitation records and hospital notes. Airway devices used during cardiac arrest were recorded as basic (adjuncts or bag-mask), or advanced, including supraglottic airway devices, tracheal tubes or tracheostomies. Descriptive statistics and multivariable regression modelling were used for data analysis. RESULTS The final analysis included 598 patients. No airway management occurred in 36 (6%), basic airway device use occurred at any time in 566 (95%), basic airway device use without an advanced airway device in 182 (30%), tracheal intubation in 322 (54%), supraglottic airway in 103 (17%), and tracheostomy in 1 (0.2%). There was significant variation in airway device use between centres. The intubation rate ranged between 21-90% while supraglottic airway use varied between 1-45%. The choice of tracheal intubation vs. supraglottic airway as the second advanced airway device was not associated with immediate survival from the resuscitation attempt (odds ratio 0.81; 95% confidence interval 0.35-1.8). CONCLUSION There is wide variation in airway device use during resuscitation after IHCA. Only half of patients are intubated before return of spontaneous circulation and many are managed without an advanced airway. Further investigation is needed to determine optimal airway device management strategies during resuscitation following IHCA.

中文翻译：

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院内心脏骤停期间的气道管理：一项国际、多中心、回顾性、观察性队列研究

目的 确定在院内心脏骤停 (IHCA) 复苏尝试期间使用的气道装置类型。方法 对 2016 年 4 月至 2018 年 9 月因心脏骤停接受胸外按压的 18 岁以上住院患者的国际多中心回顾性观察研究。患者从复苏登记和快速反应系统数据库中确定。通过查看复苏记录和医院记录收集数据。心脏骤停期间使用的气道装置被记录为基本（辅助或气囊面罩）或高级，包括声门上气道装置、气管插管或气管切开术。描述性统计和多变量回归模型用于数据分析。结果 最终分析包括 598 名患者。36 例 (6%) 未进行气道管理，566 人 (95%) 在任何时间使用基础气道装置，182 人 (30%) 未使用高级气道装置使用基础气道装置，322 人 (54%) 使用气管插管，103 人 (17%) 使用声门上气道，以及气管切开术 1 (0.2%)。中心之间的气道设备使用存在显着差异。插管率在 21-90% 之间，而声门上气道的使用在 1-45% 之间变化。选择气管插管与声门上气道作为第二高级气道装置与复苏尝试后的即刻存活率无关（优势比 0.81；95% 置信区间 0.35-1.8）。结论 IHCA 后复苏期间气道装置的使用存在很大差异。只有一半的患者在自主循环恢复之前插管，许多患者在没有高级气道的情况下进行管理。