Resuscitation Plus
Supraglottic airway versus endotracheal intubation in out-of-hospital cardiac arrest: a systematic review and meta-analysis
By Bianca S. Costa, Maria Clara P. Colla, Jonathas William de Morais and 11 others.
Abstract
Purpose
Evidence comparing supraglottic airway with tracheal intubation in out-of-hospital cardiac arrest remains conflicting, and prior meta-analyses covered few randomized trials. We compared these strategies in adults.
Methods
PubMed, Embase, and the Cochrane Library were searched from inception to January 2026 for randomized and observational studies comparing the two strategies in adults. Primary outcomes were survival to hospital discharge and return of spontaneous circulation (ROSC); favorable neurological outcome was secondary. Risk of bias was assessed with ROBINS-I and RoB 2, and certainty with GRADE. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using restricted maximum likelihood random-effects models, with heterogeneity ( I 2 ), subgroup, sensitivity, meta-regression, and exploratory trial sequential analyses.