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Vol 9, No 1 (2024)
Original article
Published online: 2024-02-15
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The impact of the COVID-19 pandemic on airway management with supraglottic airway devices among out-of-hospital cardiac arrests: a systematic review and meta-analysis

Miroslaw Dabkowski1, Karol Bielski2, Michal Pruc12, Dawid Kacprzyk1, Nicola Luigi Bragazzi3, Katarzyna Jaroszuk4, Aldona Kubica5, Damian Świeczkowski6, Malgorzata Kietlinska7, Lukasz Szarpak789
DOI: 10.5603/mrj.98670
·
Medical Research Journal 2024;9(1):82-89.
Affiliations
  1. Research Unit, Polish Society of Disaster Medicine, Warsaw, Poland
  2. Department of Public Health, International European University, Kyiv, Ukranie
  3. Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, ON, Canada
  4. Students Research Club, Maria Sklodowska-Curie Medical Academy, Warsaw, Poland
  5. Department of Health Promotion, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Bydgoszcz, Poland
  6. Department of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, Gdansk, Poland
  7. Department of Clinical Research and Development, LUXMED Group, Warsaw, Poland
  8. Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
  9. Research Unit, Maria Sklodowska-Curie Bialystok Oncology Center, Bialystok, Poland

open access

Vol 9, No 1 (2024)
ORIGINAL ARTICLES
Published online: 2024-02-15

Abstract

Introduction: The COVID-19 pandemic has led to increased cases of out-of-hospital cardiac arrest (OHCA),
impacting emergency medical services and necessitating changes in resuscitation protocols to protect
healthcare workers from virus transmission. Amidst these challenges, there’s a shift in prehospital airway
management techniques, with a renewed focus on endotracheal intubation over supraglottic airway devices
for better protection against aerosol spread during cardiopulmonary resuscitation. This systematic
review and meta-analysis aimed to examine the influence of the COVID-19 pandemic on the use of SGA
as a method of securing the airway during out-of-hospital cardiac arrest.

Material and methods: PubMed Central, Scopus, EMBASE, and the Cochrane Library databases were
systematically searched. English-language literature was searched up to December 5th, 2023. This search
was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
statement. Fixed and random effects models were used to undertake the meta-analysis when appropriate.
The risk of bias was assessed through the Newcastle-Ottawa Scale.

Results: Fifteen studies met the inclusion criteria for the meta-analysis. Pooled analysis showed that
SGAs were chosen as the method of airway protection in 46.3% and 49.8% of cases, pre- vs. during the
COVID-19 pandemic (OR = 0.76; 95%CI: 0.65 to 0.90; p = 0.001). In the case of endotracheal intubation,
statistically significant differences were also observed in the frequency of use during OHCA in the
pre-pandemic period vs. during the COVID-19 pandemic period (19.0% vs. 14.2%, respectively; OR =
1.66; 95%CI: 1.20 to 2.28; p = 0.002).

Conclusions: The study’s conclusions indicate a significant increase in the use of supraglottic airway devices
during the COVID-19 pandemic for out-of-hospital cardiac arrests. Additionally, a decrease in the use of
endotracheal intubation was observed. Effective airway management correlates with better outcomes after
cardiac arrests, although the specific impact of these techniques during the pandemic remains unclear.

Abstract

Introduction: The COVID-19 pandemic has led to increased cases of out-of-hospital cardiac arrest (OHCA),
impacting emergency medical services and necessitating changes in resuscitation protocols to protect
healthcare workers from virus transmission. Amidst these challenges, there’s a shift in prehospital airway
management techniques, with a renewed focus on endotracheal intubation over supraglottic airway devices
for better protection against aerosol spread during cardiopulmonary resuscitation. This systematic
review and meta-analysis aimed to examine the influence of the COVID-19 pandemic on the use of SGA
as a method of securing the airway during out-of-hospital cardiac arrest.

Material and methods: PubMed Central, Scopus, EMBASE, and the Cochrane Library databases were
systematically searched. English-language literature was searched up to December 5th, 2023. This search
was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)
statement. Fixed and random effects models were used to undertake the meta-analysis when appropriate.
The risk of bias was assessed through the Newcastle-Ottawa Scale.

Results: Fifteen studies met the inclusion criteria for the meta-analysis. Pooled analysis showed that
SGAs were chosen as the method of airway protection in 46.3% and 49.8% of cases, pre- vs. during the
COVID-19 pandemic (OR = 0.76; 95%CI: 0.65 to 0.90; p = 0.001). In the case of endotracheal intubation,
statistically significant differences were also observed in the frequency of use during OHCA in the
pre-pandemic period vs. during the COVID-19 pandemic period (19.0% vs. 14.2%, respectively; OR =
1.66; 95%CI: 1.20 to 2.28; p = 0.002).

Conclusions: The study’s conclusions indicate a significant increase in the use of supraglottic airway devices
during the COVID-19 pandemic for out-of-hospital cardiac arrests. Additionally, a decrease in the use of
endotracheal intubation was observed. Effective airway management correlates with better outcomes after
cardiac arrests, although the specific impact of these techniques during the pandemic remains unclear.

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Keywords

COVID-19; pandemic; airway management; supraglottic airway devices; endotracheal tube; out-of-hospital cardiac arrests; systematic review; meta-analysis

About this article
Title

The impact of the COVID-19 pandemic on airway management with supraglottic airway devices among out-of-hospital cardiac arrests: a systematic review and meta-analysis

Journal

Medical Research Journal

Issue

Vol 9, No 1 (2024)

Article type

Original article

Pages

82-89

Published online

2024-02-15

Page views

130

Article views/downloads

64

DOI

10.5603/mrj.98670

Bibliographic record

Medical Research Journal 2024;9(1):82-89.

Keywords

COVID-19
pandemic
airway management
supraglottic airway devices
endotracheal tube
out-of-hospital cardiac arrests
systematic review
meta-analysis

Authors

Miroslaw Dabkowski
Karol Bielski
Michal Pruc
Dawid Kacprzyk
Nicola Luigi Bragazzi
Katarzyna Jaroszuk
Aldona Kubica
Damian Świeczkowski
Malgorzata Kietlinska
Lukasz Szarpak

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