Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study
Aim: To describe the incidence, characteristics, success rates, and outcomes of out-of-hospital cardiac arrest (OHCA) patients receiving cricothyroidotomy. Methods: Over an 18-year period, we retrospectively analysed patient care records and cardiac arrest registry data for cricothyroidotomy cases....
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Elsevier
2024-12-01
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| Series: | Resuscitation Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666520424002844 |
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| author | Matthew Humar Benjamin Meadley Bart Cresswell Emily Nehme Christopher Groombridge David Anderson Ziad Nehme |
| author_facet | Matthew Humar Benjamin Meadley Bart Cresswell Emily Nehme Christopher Groombridge David Anderson Ziad Nehme |
| author_sort | Matthew Humar |
| collection | DOAJ |
| description | Aim: To describe the incidence, characteristics, success rates, and outcomes of out-of-hospital cardiac arrest (OHCA) patients receiving cricothyroidotomy. Methods: Over an 18-year period, we retrospectively analysed patient care records and cardiac arrest registry data for cricothyroidotomy cases. Multivariable logistic regression analysis was used to examine associations between study characteristics and cricothyroidotomy success. Results: We identified 80 cricothyroidotomies, 56 of which occurred in OHCA. The incidence of cricothyroidotomy in OHCA was 1.1 per 1,000 attempted resuscitations and increased over the study period (incidence rate ratio [IRR] = 1.13, 95 % confidence interval [CI]: 1.02–1.25, p = 0.023). The overall success rate was 68.8 % (n = 55/80), with lower success in cardiac arrest (n = 33/56, 58.9 %) than non-cardiac arrest patients (n = 22/24, 91.7 %). In OHCA, success rates were higher for surgical compared to needle techniques (88.2 % vs. 54.6 %, p = 0.003). Cardiac arrest (odds ratio [OR] 0.09, 95 % CI 0.16–0.51) and needle techniques (OR 0.11, 95 % CI 0.02–0.56) were independently associated with lower odds of procedural success, while male sex (OR 10.06, 95 % CI 2.00–50.62) was associated with higher odds. Return of spontaneous circulation occurred in 44.6 % (n = 22/56), with 35.7 % (n = 20/56) surviving to hospital and 7.1 % (n = 4/56) surviving to hospital discharge. Procedural complications included cardiac arrest (n = 6/56, 10.7 %), minor bleeding (n = 5/56, 8.9 %), surgical emphysema (n = 3/56, 5.4 %), and major bleeding (n = 2/56, 3.6 %). Conclusion: We found cricothyroidotomy in OHCA to be associated with low rates of procedural success and high mortality rates. Further studies are required to assess the role and potential benefits of cricothyroidotomy in cardiac arrest. |
| format | Article |
| id | doaj-art-d590d1b75c9b414984abb128b3d9faaa |
| institution | DOAJ |
| issn | 2666-5204 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
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| series | Resuscitation Plus |
| spelling | doaj-art-d590d1b75c9b414984abb128b3d9faaa2025-08-20T02:40:08ZengElsevierResuscitation Plus2666-52042024-12-012010083310.1016/j.resplu.2024.100833Cricothyroidotomy in out-of-hospital cardiac arrest: An observational studyMatthew Humar0Benjamin Meadley1Bart Cresswell2Emily Nehme3Christopher Groombridge4David Anderson5Ziad Nehme6Ambulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, Australia; Department of Paramedicine, Monash University, Level 2, Building H, Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, Victoria 3199, Australia; Corresponding author at: Ambulance Victoria, 375 Manningham Road, Doncaster, PO Box 2000, Doncaster, VIC 3108, Australia.Ambulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, Australia; Department of Paramedicine, Monash University, Level 2, Building H, Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, Victoria 3199, AustraliaAmbulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, AustraliaAmbulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, Australia; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd Melbourne, Victoria 3004, AustraliaSchool of Translational Medicine, Monash University, Level 6, Alfred Centre, 99 Commercial Rd, Melbourne, Victoria 3004, Australia; National Trauma Research Institute, Level 4/89 Commercial Rd, Melbourne, Victoria 3004, Australia; The Alfred Hospital, Alfred Health, 55 Commercial Rd, Melbourne, Victoria 3004, AustraliaAmbulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, Australia; Department of Paramedicine, Monash University, Level 2, Building H, Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, Victoria 3199, Australia; The Alfred Hospital, Alfred Health, 55 Commercial Rd, Melbourne, Victoria 3004, AustraliaAmbulance Victoria, 375 Manningham Rd, Doncaster, Melbourne, Victoria 3108, Australia; Department of Paramedicine, Monash University, Level 2, Building H, Peninsula Campus, 47-49 Moorooduc Hwy, Frankston, Victoria 3199, Australia; School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Rd Melbourne, Victoria 3004, AustraliaAim: To describe the incidence, characteristics, success rates, and outcomes of out-of-hospital cardiac arrest (OHCA) patients receiving cricothyroidotomy. Methods: Over an 18-year period, we retrospectively analysed patient care records and cardiac arrest registry data for cricothyroidotomy cases. Multivariable logistic regression analysis was used to examine associations between study characteristics and cricothyroidotomy success. Results: We identified 80 cricothyroidotomies, 56 of which occurred in OHCA. The incidence of cricothyroidotomy in OHCA was 1.1 per 1,000 attempted resuscitations and increased over the study period (incidence rate ratio [IRR] = 1.13, 95 % confidence interval [CI]: 1.02–1.25, p = 0.023). The overall success rate was 68.8 % (n = 55/80), with lower success in cardiac arrest (n = 33/56, 58.9 %) than non-cardiac arrest patients (n = 22/24, 91.7 %). In OHCA, success rates were higher for surgical compared to needle techniques (88.2 % vs. 54.6 %, p = 0.003). Cardiac arrest (odds ratio [OR] 0.09, 95 % CI 0.16–0.51) and needle techniques (OR 0.11, 95 % CI 0.02–0.56) were independently associated with lower odds of procedural success, while male sex (OR 10.06, 95 % CI 2.00–50.62) was associated with higher odds. Return of spontaneous circulation occurred in 44.6 % (n = 22/56), with 35.7 % (n = 20/56) surviving to hospital and 7.1 % (n = 4/56) surviving to hospital discharge. Procedural complications included cardiac arrest (n = 6/56, 10.7 %), minor bleeding (n = 5/56, 8.9 %), surgical emphysema (n = 3/56, 5.4 %), and major bleeding (n = 2/56, 3.6 %). Conclusion: We found cricothyroidotomy in OHCA to be associated with low rates of procedural success and high mortality rates. Further studies are required to assess the role and potential benefits of cricothyroidotomy in cardiac arrest.http://www.sciencedirect.com/science/article/pii/S2666520424002844Emergency medical servicesOut-of-hospital cardiac arrestCardiopulmonary resuscitationEmergency front-of-neck accessDifficult airwayCricothyroidotomy |
| spellingShingle | Matthew Humar Benjamin Meadley Bart Cresswell Emily Nehme Christopher Groombridge David Anderson Ziad Nehme Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study Resuscitation Plus Emergency medical services Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Emergency front-of-neck access Difficult airway Cricothyroidotomy |
| title | Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study |
| title_full | Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study |
| title_fullStr | Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study |
| title_full_unstemmed | Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study |
| title_short | Cricothyroidotomy in out-of-hospital cardiac arrest: An observational study |
| title_sort | cricothyroidotomy in out of hospital cardiac arrest an observational study |
| topic | Emergency medical services Out-of-hospital cardiac arrest Cardiopulmonary resuscitation Emergency front-of-neck access Difficult airway Cricothyroidotomy |
| url | http://www.sciencedirect.com/science/article/pii/S2666520424002844 |
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