Comparison of the Esophageal Obturator Airway and Endotracheal Intubation in Prehospital Ventilation during CPR

Abstract

The esophageal obturator airway (EOA), esophagogastric tubular airway (EGT) and endotracheal (ET) intubation are compared as they relate to blood gases during CPR. Although statistically better levels of gases are obtained with the endotracheal tube in patients who had an EOA inserted previously, no difference in survival is noted in a separate prospective and retrospective series of patients in whom the devices were used in the field. Furthermore, there was no difference in morbidity, neurologic deficit, or functional capacity. In three of five series in which physician-directed CPR was carried out, there was no difference observed in PO2 levels when the EOA and ET tube were used consecutively, and patients with fixed volume ventilators on 100 percent oxygen have statistically similar blood gas levels with the EOA as they do with the endotracheal tube. It would appear that patients with a PO2 of less than 60 mm Hg do not tend to survive. The endotracheal tube remains the gold standard, although its universal use is impractical, while the EOA would appear to be an effective alternative and an important airway adjunct in the prehospital phase of CPR.