A standard comparison of esophageal obturator airway and endotracheal tube ventilation in cardiac arrest

Abstract

A comparison of esophageal obturator airway (EOA) and endotracheal tube (ET) ventilation was performed while standardizing the method of oxygen delivery and assuring true sampling of arterial blood. Forty-eight victims of prehospital cardiac arrest had an arterial blood gas drawn in the emergency department while being ventilated with an EOA. Endotracheal intubation was performed immediately thereafter and another blood gas was drawn. All patients without a pulse were sampled through an arterial line placed by cutdown. Patients who developed a pulse during the resuscitation were sampled percutaneously or by arterial line. Patients with a perfusing rhythm (N = 19) had the following mean EOA blood gas values: pH, 7.34 +/- .17; PCO2, 28 +/- 8 mm Hg; and PO2, 420 +/- 125 mm Hg. Their subsequent mean ET blood gas values were pH, 7.40 +/- .13; PCO2, 25 +/- 8 mm Hg; and PO2, 390 +/- 100 mm Hg. Pulseless patients (N = 29) had mean EOA blood gas values of pH, 7.36 +/- .26; PCO2, 32 +/- 21 mm Hg; and PO2, 285 +/- 192 mm Hg. Their subsequent mean ET blood gas values were pH, 7.30 +/- .21; PCO2, 36 +/- 26 mm Hg; and PO2, 260 +/- 185 mm Hg. There was no statistically significant difference in the PCO2 or PO2 obtained with EOA compared with ET ventilation. There was a significant difference in the pH corrected for respiratory acidosis in pulseless patients, but not in patients with a perfusing rhythm.(ABSTRACT TRUNCATED AT 250 WORDS)