{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T06:24:15Z","timestamp":1786947855463,"version":"build-2736575974"},"reference-count":52,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the effectiveness and safety of laryngeal mask airway (LMA) versus endotracheal intubation (ETI) on resuscitation outcomes in patients with out-of-hospital cardiac arrest (OHCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Randomized controlled trials (RCTs) were searched in PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and CBM from database inception to May 31, 2025. The methodological quality and risk of bias of the included RCTs were evaluated with the Cochrane ROB2 tool. We employed RevMan 5.3 and TSA software for all statistical analyses, including meta-analysis, sensitivity analysis, and trial sequential analysis (TSA). The certainty of the evidence was graded according to the GRADE approach. The primary outcomes included airway establishment time and CPR success rate, and the secondary outcomes included first-attempt intubation success rate, mortality, survival rate, left ventricular ejection fraction, and adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nineteen RCTs (11,982 patients) were included. Compared with ETI, LMA was associated with a significantly shorter airway establishment time (MD: \u221286.95\u202fs; 95% CI: \u2212103.00, \u221270.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001), higher first-attempt success rate (RR: 1.44; 95% CI: 1.32, 1.58;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001), improved CPR success rate (RR: 1.44; 95% CI: 1.25, 1.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001), and LVEF (SMD: 1.57; 95% CI: 0.65, 2.48;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.00001). No significant differences were observed in survival rate (RR: 0.98; 95% CI: 0.88, 1.09;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.69), nor mortality (RR: 1.00; 95% CI: 0.99, 1.01;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.69). LMA was associated with a lower rate of vocal cord injury (RR: 0.11; 95% CI: 0.03, 0.47;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.003), although this finding is based on a small number of events and should be interpreted cautiously. The quality of the GRADE evidence ranged from very low to high.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Compared with ETI, LMA demonstrates significantly higher operational efficiency and a favorable safety profile in the management of OHCA. However, given that survival and mortality outcomes are comparable between the two strategies, LMA may be considered a reasonable alternative to ETI, particularly when minimizing interruptions in chest compressions is a priority or when ETI expertise is limited. The choice of airway device should be individualized rather than uniformly prioritized. In summary, LMA may offer procedural advantages and fewer airway-related complications, while evidence for a survival benefit remains insufficient.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42025645299<\/jats:ext-link>\n                      , identifier (CRD42025645299).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1877439","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T05:25:42Z","timestamp":1786944342000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of laryngeal mask airway versus endotracheal intubation on survival in out-of-hospital cardiac arrest: a meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"14","author":[{"given":"Dongxia","family":"Zhang","sequence":"first","affiliation":[{"name":"The Second Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Li","sequence":"additional","affiliation":[{"name":"The First Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaofan","family":"Mo","sequence":"additional","affiliation":[{"name":"The Second Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huazhen","family":"Xie","sequence":"additional","affiliation":[{"name":"The First Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihui","family":"Lin","sequence":"additional","affiliation":[{"name":"The Second Clinical College of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quanle","family":"Liu","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruifeng","family":"Zeng","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danwen","family":"Zheng","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotu","family":"Xi","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zunjiang","family":"Li","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Banghan","family":"Ding","sequence":"additional","affiliation":[{"name":"The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"23185","DOI":"10.1038\/s41598-024-74117-w","article-title":"Detecting cardiac 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