6/28/23, 12:05 AM AIRWAY-2 Pathway Feedback Search Clinical Topics Home Studies AIRWAY 2 AIRWAY 2 Disease Cardiac arrest Trial question What is the effect of a strategy of advanced airway management with a supraglottic airway device among patients with out-of-hospital cardiac arrest? Study design Multi-center Open label RCT Population Characteristics of study participants 36.0% female N = 9296 64.0% male 9296 patients (3373 female, 5923 male) Inclusion criteria: adult patients who had a nontraumatic out-of-hospital cardiac arrest and were treated by a participating paramedic Key exclusion criteria: resuscitation deemed inappropriate; advanced airway already in place when a paramedic participating in the trial arrived at the patient's side; and the patient's mouth opening < 2 cm Interventions N=4886 supraglottic airway device (i-gel use; Intersurgical by 759 paramedics) N=4410 tracheal intubation (direct laryngoscopy use764 by paramedics) https://web.pathway.md/studies/recjKFVTZ0ecXYKmD 1/2 6/28/23, 12:05 AM AIRWAY-2 Pathway Primary outcome Good outcome; modified Rankin Scale score range of 0-3 6.8 % 6.8 6.4 5.1 % 3.4 % 1.7 % No significant difference 0.0 % Supraglottic airway device Tracheal intubation No significant difference in good outcome; mRS score range of 0-3 (6.4% vs. 6.8%; aOR 0.92, 95% CI 0.77 to 1.09) Secondary outcomes No significant difference in survival at 72 hour (13.6% vs. 13.1%; OR 1.04, 95% CI 0.92 to 1.18) Significant increase in initial ventilation success; 2 attempts at advanced airway management (87.4% vs. 79%; OR 1.92, 95% CI 1.66 to 2.22) Significant increase in any unintended loss of a previously established airway (10.6% vs. 5%; OR 2.29, 95% CI 1.86 to 2.82) Safety outcomes No significant differences in regurgitation, aspiration. Significant difference in ROSC at arrival to the emergency department or hospital (30.6% vs. 28.4%). Conclusion In adult patients who had a nontraumatic out-of-hospital cardiac arrest and were treated by a participating paramedic, supraglottic airway device was not superior to tracheal intubation with respect to good outcome; mRS score range of 0-3. Reference Jonathan R Benger, Kim Kirby, Sarah Black et al. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome: The AIRWAYS-2 Randomized Clinical Trial. JAMA. 2018 Aug 28;320(8):779-791. Open reference URL https://web.pathway.md/studies/recjKFVTZ0ecXYKmD 2/2