Bag-mask ventilation fails to improve on intubation in cardiac arrest

Aug. 28 (UPI) -- Results from the recent CAAM trial reveal that bag-mask ventilation fails to improve on endotracheal intubation for out-of-hospital cardiac arrest patients, researchers who conducted the trial report.

Airway management with endotracheal intubation is the standard of care in cardiopulmonary resuscitation for out-of-hospital cardiac arrest patients.

"Sudden cardiac arrest is the main cause of death worldwide in previously healthy people," Dr. Frederic Adnet, an emergency physician at Avicenne Hospital in Bobigny, France, said in a press release. "Each year it causes 300,000 deaths in the U.S. and more than 200,000 in Europe. Less than 10 percent of patients survive out-of-hospital cardiac arrest."

The CAAM trial was a controlled, multicenter trial that compared the impact of airway management with bag-mask ventilation, or BMV, compared and endotracheal intubation, or ETI, on survival with healthy brain function in out-of-hospital cardiac arrest patients.

The study, presented today at the ESC Congress 2017, included 2,043 out-of-hospital cardiac arrest patients from 15 centers in France and five in Belgium who were randomized to receive BMV or ETI during cardiopulmonary resuscitation.

Researchers found a 4.2 percent rate of survival with good neurological outcome with BMV and 4.3 percent with ETI, however, the BMV method failed in 6.7 percent of patients compared to 2.1 percent with ETI. There was also a higher rate of regurgitation or aspiration with BMV of 15.2 percent compared to 7.5 percent with ETI.

"Bag-mask ventilation did not appear to be without danger in our trial," Adnet said. "We were surprised by the much higher incidence of failure of the BMV technique compared with ETI. The higher incidence of regurgitation/aspiration in the BMV group confirms previous studies linking BMV with risks for the patient."