Effect of Intermediate Airway Management on Ventilation Parameters in Simulated Pediatric Out-of-Hospital Cardiac Arrest: Protocol for a Multicenter, Randomized, Crossover Trial

Children (Basel). 2023 Jan 12;10(1):148. doi: 10.3390/children10010148.


Most pediatric out-of-hospital cardiac arrests (OHCAs) are caused by hypoxia, which is generally consecutive to respiratory failure. To restore oxygenation, prehospital providers usually first use basic airway management techniques, i.e., bag-valve-mask (BVM) devices. These devices present several drawbacks, most of which could be avoided using supraglottic airway devices. These intermediate airway management (IAM) devices also present significant advantages over tracheal intubation: they are associated with higher success and lower complication rates in the prehospital setting. There are, however, few data regarding the effect of early IAM in pediatric OHCA. This paper details the protocol of a trial designed to evaluate the impact of this airway management strategy on ventilation parameters through a simulated, multicenter, randomized, crossover trial. The hypothesis underlying this study protocol is that early IAM without prior BVM ventilations could improve the ventilation parameters in comparison with the standard approach, which consists in BVM ventilations only.

Keywords: airway management; cardiopulmonary resuscitation; emergency medical services; i-gel; laryngeal masks; non-invasive ventilation; out-of-hospital cardiac arrest; pediatrics.

Grants and funding

The APC was funded by donations from “Swissrescue.ch—Website for Prehospital Healthcare Providers”, the commune of Ecublens (VD), Clinique Bois-Cerf (Hirslanden) and Judit Rigoli.