ArticleResuscitation2021
Bougie-assisted endotracheal intubation in the pragmatic airway resuscitation trial.
Article in Resuscitation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy of tracheal tube introducers and stylets for endotracheal intubation in the prehospital setting: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Pooled it
- Reality matters: in-field validation of fresh frozen cadaver-based airway training in HEMS - the BOAH Initiative: a prospective observational cohort study.BMC emergency medicine · 2026Observational
- Airway management analysis in the rescue environment of the emergency service Zug: a retrospective real-world evaluation.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Longitudinal Changes in Emergency Medical Services Advanced Airway Management.JAMA network open · 2024Article
- Re-creating reality: validation of fresh frozen full cadaver airway training with videolaryngoscopy and bougie FIRST strategy : The BOAH-course: a prospective, observational study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Observational
- Drug-free tracheal intubation by specialist paramedics (critical care) in a United Kingdom ambulance service: a service evaluation.BMC emergency medicine · 2021Article
- A comparison of AIROD and conventional bougie as an intubation guide in simulated difficult airway: A prospective randomized study.Journal of anaesthesiology, clinical pharmacologyArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
objectiveParamedics may perform endotracheal intubation (ETI) while treating patients with out-of-hospital cardiac arrest (OHCA). The gum elastic Bougie (Bougie) is an intubation adjunct that may optimize intubation success. There are few reports of Bougie-assisted intubation in OHCA nor its association with outcomes. We compared intubation success rates and OHCA outcomes between Bougie-assisted and non-Bougie ETI in the out-of-hospital Pragmatic Airway Resuscitation Trial (PART).
methodsThis was a secondary analysis of patients receiving ETI enrolled in the Pragmatic Airway Resuscitation Trial (PART), a multicenter clinical trial comparing intubation-first vs. laryngeal tube-first strategies of airway management in adult OHCA. The primary exposure was use of Bougie for ETI-assistance. The primary endpoint was first-pass ETI success. Secondary endpoints included overall ETI success, time to successful ETI, return of spontaneous circulation, 72-h survival, hospital survival and hospital survival with favorable neurologic status (Modified Rankin Score ≤3). We analyzed the data using Generalized Estimating Equations and Cox Regression, adjusting for known confounders.
resultsOf the 3004 patients enrolled in PART, 1227 received ETI, including 440 (35.9%) Bougie-assisted and 787 (64.1%) non-Bougie ETIs. First-pass ETI success did not differ between Bougie-assisted and non-Bougie ETI (53.1% vs. 42.8%; adjusted OR 1.12, 95% CI: 0.97-1.39). ETI overall success was slightly higher in the Bougie-assisted group (56.2% vs. 49.1%; adjusted OR 1.19, 95% CI: 1.01-1.32). Time to endotracheal tube placement or abandonment was longer for Bougie-assisted than non-Bougie ETI (median 13 vs. 11 min; adjusted HR 0.63, 95% CI: 0.45-0.90). While survival to hospital discharge was lower for Bougie-assisted than non-Bougie ETI (3.6% vs. 7.5%; adjusted OR 0.94, 95% CI: 0.92-0.96), there were no differences in ROSC, 72-h survival or hospital survival or hospital survival with favorable neurologic status.
conclusionWhile exhibiting slightly higher ETI overall success rates, Bougie-assisted ETI entailed longer airway placement times and potentially lower survival. The role of the Bougie assistance in ETI of OHCA remains unclear.
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