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SGA vs intubation in OHCA: ROSC lower with SGA

Supraglottic airway versus endotracheal intubation in out-of-hospital cardiac arrest: a systematic review and meta-analysis
Resuscitation Plus · Added 25 September 2026

Systematic review and meta-analysis comparing supraglottic airway devices with endotracheal intubation in out-of-hospital cardiac arrest. Abstract not yet available (ahead-of-print).

Study type

Systematic review

Design

Systematic review and meta-analysis (random-effects, GRADE)

Participants

13 studies, 246,659 adults with OHCA

Main finding

Survival to hospital discharge did not differ (RR 0.96, 95% CI 0.82–1.12). SGA was associated with lower ROSC than tracheal intubation (RR 0.86, 95% CI 0.77–0.96; prehospital RR 0.82, 95% CI 0.71–0.95), but in the two RCTs SGA was associated with higher ROSC (RR 1.09, 95% CI 1.03–1.16). Favourable neurologic outcome did not differ overall (RR 0.99, 95% CI 0.88–1.11); exploratory ≥1-month subgroup favoured TI (RR 0.90, 95% CI 0.81–0.99).

Caveat

Mostly observational evidence with substantial heterogeneity (I² up to 96%) and reversal of direction in RCTs

Bottom line

Hypothesis-generating

Learning goal

Weigh the benefits and harms of supraglottic airway versus tracheal intubation during out-of-hospital cardiac arrest management.

More

• Topic: Airway & ventilation
• Daily scan: 25 September 2026

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