In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

Bag-mask ventilation appears less safe than endotracheal intubation in cardiac arrest

Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care


Airway management with bag-mask ventilation (BMV) failed to improve on endotracheal intubation (ETI) in out-of-hospital cardiac arrest patients, and was associated with significantly more failures and complications, according to results from the CAAM trial presented yesterday in a Hot Line LBCT Session.

While airway management with ETI has been the standard of care in resuscitation of out-of-hospital cardiac arrest victims, observational studies have suggested that survival is lower when it is used. BMV is a less complex technique than ETI. Some studies have proposed that bag-mask ventilation is safer and may avoid the adverse effects of ETI during resuscitation. The CAAM trial was a prospective, randomised, controlled,

The CAAM trial was a prospective, randomised, controlled, multicentre trial that compared the impact of airway management with BMV versus ETI on survival with healthy brain function in 2,043 out-of-hospital cardiac arrest patients. Principal investigator Professor Frédéric Adnet (Avicenne Hospital, Bobigny, France) reported that 20 emergency medical services centres in France and Belgium randomised patients when resuscitation was attempted to either receive tracheal intubation (control group) or bag-mask ventilation. The primary outcome was survival to 28 days with good neurological outcome. The investigators found the same rate of survival with

Principal investigator Professor Frédéric Adnet (Avicenne Hospital, Bobigny, France) reported that 20 emergency medical services centres in France and Belgium randomised patients when resuscitation was attempted to either receive tracheal intubation (control group) or bag-mask ventilation. The primary outcome was survival to 28 days with good neurological outcome. The investigators found the same rate of survival with

The investigators found the same rate of survival with good neurological outcome at day 28 in the two groups (4.2% with BMV vs. 4.3% with ETI). However, the BMV technique failed in 6.3% of patients as compared with ETI, which failed in 2.5% (p<0.0001). There was also much greater incidence of gastric content regurgitation/aspiration with BMV (14.9%) compared to ETI (7.7%; p<0.0001).

Prof. Adnet said: “BMV appears less safe than ETI as a means of ventilation during cardiopulmonary resuscitation in out-of-hospital cardiac arrest. Thus, we cannot recommend BMV as the standard method to ventilate out-of-hospital cardiac arrest patients during cardiopulmonary resuscitation.”

resources of the presentation: Airway management during cardiopulmonary resuscitation: Tracheal intubation versus bag valve mask ventilation

Click here to read other scientific highlights in the full edition of the Congress news.