AIRWAYS-3 Trial: Advanced Airway Management in IHCA
"AIRWAYS-3 is a multi-centre trial comparing supraglottic airway (SGA) to tracheal intubation for in-hospital cardiac arrest. Led by Prof. Jonathan Benger, it aims to determine clinical effectiveness and cost-effectiveness. The study involves an internal pilot, with a focus on functional outcomes and health-related quality of life. Stay updated on this groundbreaking research in advanced airway management during cardiac arrest."
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Presentation Transcript
An RCT of advanced airway management for patients who have suffered an in-hospital cardiac arrest (IHCA) AIRWAYS-3 is a multi-centre, open-label, randomised trial and economic evaluation to determine the clinical and cost effectiveness of a supraglottic airway (SGA) versus tracheal intubation during in-hospital cardiac arrest.
AIRWAYS-3 CARDIAC ARREST CPD WEBINAR Professor Jonathan Benger: AIRWAYS-3 Updates Professor Jerry Nolan: Cardiac arrest centres Dr Keith Couper: Double sequential fibrillation Dr Jasmeet Soar: Perioperative airways complications and cardiac arrest
Randomised trial of the clinical and cost effectiveness of a supraglottic airway device versus tracheal intubation during in-hospital cardiac arrest (AIRWAYS-3) Chief Investigator: Prof. Jonathan Benger CBE Sponsor:University Hospitals Bristol and Weston Coordinating Centre: Warwick Clinical Trials Unit Funder: National Institute for Health and Care Research Contact: airways3@warwick.ac.uk Website: www.warwick.ac.uk/airways3
Design A multi-centre, open-label, pragmatic, individually randomised, parallel group, superiority trial and economic evaluation to determine the clinical and cost effectiveness of a supraglottic airway (SGA) versus tracheal intubation (TI) during in-hospital cardiac arrest (IHCA). The trial will include an internal pilot to confirm feasibility Population Adult hospital in patients receiving resuscitation following IHCA that requires a 2222 call and advanced airway management Intervention Supraglottic airway device (SGA) Comparator Tracheal intubation Outcome Functional status at hospital discharge (or 30 days post-randomisation whichever is shorter) as measured by the modified Rankin Scale (mRS) Setting UK hospitals; international recruitment under consideration Sample size 4,190 participants (2,095 per group) 1st Dec 2022 (30 pilot sites) then January 2024 (80 trial sites) for 18 months Recruitment Period
Aim of the AIRWAYS-3 trial 1. Conduct an internal pilot study to confirm the feasibility of the large-scale multi-centre trial. 2. Determine the clinical effectiveness of SGA versus tracheal intubation, for adults with in-hospital cardiac arrest, in terms of survival with a favourable functional outcome and health-related quality of life. 3. Estimate, in an integrated economic evaluation, the cost- effectiveness of SGA compared with tracheal intubation.
AIRWAYS-3 so far Meeting with funder 06/02/2024 confirmed successful completion of pilot phase 51 sites open across 35 trusts in England and Wales and in all LCRNs 783 participants randomised Best month of recruitment July 2024 with 66 participants >1500 staff completed training 76 Associate PIs in total Meeting with funder 16/09/2024 to review trial progress
Recruitment and site update 2500 2000 Current recruitment total: 783 1500 1000 772 690 624 563 500 501 443 389 343 233 278 123154199 97 74 59 37 23 12 9 0 1 Targets Recruitment Projections
51 open sites Bristol Royal (UHBW) Royal Preston RUH Bath East Kent (QETQM) Hammersmith Pinderfields North Bristol - Southmead Sherwood Forest Hospitals Bradford Royal Infirmary Gloucestershire Princess Alexandra Great Western Rotherham Weston General (UHBW) Liverpool University Hospitals NHS FT Worcester Royal Alexandra Hospital Maidstone Hospital Tunbridge wells Hospital St George's University Hospitals NHS FT Worthing Hospital (UHS) Royal Devon and Exeter Wye Valley Trust - Hereford Whiston Hospital Princess Royal Hospital Royal Sussex County UHD - Poole Hospital UHD - Bournemouth Hospital The Queen Elizabeth Hospital Kings Lynn Heartlands Hospital St Richards William Harvey (UKUHFT) Good Hope Hospital Ealing Hospital Northwick Park Hospital Ysbyty Gwynedd New Cross Hospital Wrexham Maelor Hospital Southport and Formby District General Hospital West Middlesex University Hospital York and Scarborough University Hospital Wales University Hospital Llandough Queens Hospital, Barking North Tees and Hartlepool NHS Foundation Trust Chelsea and Westminster Lincoln County Hospital Royal Glamorgan Hospital Scarborough General Hospital Pilgrim Hospital Sheffield Teaching Hospitals NHS Foundation Trust
Eligibility Criteria change in January Adult (known or believed to be age >=18 years). Patients who have a cardiac arrest outside hospital and who are transported to the hospital in ongoing cardiac arrest In-hospital cardiac arrest, attended by the hospital cardiac arrest team in response to a cardiac arrest call (2222 or equivalent), and when a clinician permitted to undertake both tracheal intubation and supraglottic airway placement (so that either intervention can be delivered) is present. People who are not a hospital inpatient (e.g. visitor, relative, staff or outpatient). Patients who are already tracheally intubated at the time of eligibility assessment. Patients known to be pregnant. Undergoing resuscitation and requiring advanced airway management in the opinion of the trained clinician responsible for randomisation. Patients with a functioning tracheostomy
Training Training for AIRWAYS-3 is very short and hosted on our website: Airways3 training (warwick.ac.uk) You must complete the form at the end of the training slides (Airways3 Training Checklist (warwick.ac.uk)), or email airways3@warwick.ac.uk to confirm your training Once you have completed the training (and are at an open site) we will send you a PWA login code and you ll be ready to randomise AIRWAYS-3 RAND APP (warwick.ac.uk)
