Title: Airway management in out of hospital cardiac arrest
题目：院外心搏骤停(OHCA)的气道管理
Author 作者: Ali Farzad，葛云 译 肖锋 校

Optimal out of hospital cardiac arrest (OHCA) airway management strategies remain unclear. In the US, 80% of OHCA patients receive prehospital airway management, most commonly endotracheal intubation (ETI). There is growing enthusiasm for use of supra-glottic airways (SGA) by EMS because of ease of insertion, and the thought that use of SGA reduces interruptions in chest compressions. More recently, studies have suggested improved survival without the insertion of any advanced airway device at all. 
最佳的OHCA气道管理策略尚不明确。在美国，80%的OHCA患者接受了院前的气道管理，最常见的是气管内插管（ETI）。急诊医疗体系（EMS）中越来越多地使用声门上气道（SGA），由于它更容易插入，且可减少中断胸外按压 。最近研究表明，没有使用任何高级气道方法能提高患者存活率。

A recent secondary analysis of OHCA outcomes in the Cardiac Arrest Registry to Enhance Survival (CARES) compared patients receiving endotracheal intubation (ETI) versus supra-glottic airway (SGA), and also patients receiving [ETI or SGA] with those receiving no advanced airway. 
最近增加心脏骤停存活率（CARES）研究进一步分析并比较了接受ETI或SGA，及没有接受高级气道的三类患者的预后。

Of 10,691 OHCA, 5591 received ETI, 3110 SGA, and 1929 had no advanced airway. Unadjusted neurologically-intact survival was: ETI 5.4%, SGA 5.2%, no advanced airway 18.6%. Compared with SGA, ETI achieved higher sustained ROSC, survival to hospital admission, hospital survival, and hospital discharge with good neurologic outcome. Moreover, compared with [ETI or SGA], patients who received no advanced airway attained higher survival to hospital admission, hospital survival, and hospital discharge with good neurologic outcome. 
OHCA患者共10691例，接受ETI的有5591例，接受SGA的有3110例，没有接受高级气道的有1929例。复苏后未校正的神经功能正常的存活率：ETI 5.4%，SGA 5.2%，无高级气道18.6%。在入院、院内和出院保留神经功能良好的存活者中，与SGA相比，ETI更能获得持续地自主循环恢复。然而，与ETI或SGA相比，没有接受高级气道的患者在入院、住院和出院期间具有更高的神经功能良好的存活率。

Conclusion: In CARES, patients receiving no advanced airway exhibited superior outcomes than those receiving ETI or SGA. When an advanced airway was used, ETI was associated with improved outcomes compared to SGA.
结论：在CARES研究中，没有接受高级气道的患者比接受ETI或SGA患者有更好的预后。而当使用高级气道时，ETI比SGA更佳。

References 参考文献:
McMullan J, Gerecht R, Bonomo J, et al. Airway management and out-of-hospital cardiac arrest outcome in the CARES registry. Resuscitation. 2014;85(5):617–622. doi:10.1016/j.resuscitation.2014.02.007.