COMPARISON OF DIFFERENT AIRWAY MANAGEMENT TECHNIQUES IN CARDIOPULMONARY RESUSCITATION: BAG-VALVE VENTILATION VERSUS ENDOTRACHEAL TUBE AND LARYNGEAL MASK AIRWAY

Abstract

Objectives:
Out-of-hospital cardiac arrest (OHCA) remains a leading cause of mortality worldwide. Effective airway management during cardiopulmonary resuscitation (CPR) is essential for improving return of spontaneous circulation (ROSC) and survival outcomes. This study aimed to compare the effectiveness, procedural efficiency, and provider satisfaction associated with Bag-Valve Mask (BVM) ventilation, Endotracheal Tube (ETT) intubation, and Laryngeal Mask Airway (LMA) insertion during CPR.

Methodology:
A comparative research design was conducted in emergency departments and pre-hospital settings. A total of 150 adult cardiac arrest patients were equally divided into three groups (n=50 each): BVM, ETT, and LMA. Quantitative variables included ROSC, SpO₂, ETCO₂, time to secure the airway, number of attempts, duration of CPR, survival to admission, and survival to discharge. Qualitative variables included ease of insertion, perceived ventilation effectiveness, complications, and provider satisfaction. Data were analyzed using descriptive and inferential statistics with a significance level of p < 0.05.

Results:
The ETT group demonstrated the highest ROSC (68%) and survival to discharge (34%) rates, along with superior oxygenation parameters. However, it required longer airway securing time and more attempts. The LMA group showed a balanced performance with favorable clinical outcomes, rapid insertion, and the highest provider satisfaction. The BVM group had the shortest airway securing time but comparatively lower long-term survival and higher gastric insufflation rates. Statistically significant differences were observed among the groups in ROSC, oxygenation parameters, airway securing time, and survival outcomes.

Conclusion:
ETT provided superior airway protection and improved survival outcomes but required advanced technical skill. LMA offered a practical and effective alternative, particularly in emergency and pre-hospital settings. BVM remained the fastest initial intervention but was associated with comparatively lower long-term outcomes.