The esophageal obturator airway. A clinical evaluation

The esophageal obturator airway (EOA) has been considered a useful ventilatory technique for cardiopulmonary resuscitation, but quantitative analysis of its clinical effectiveness is not available. We evaluated the EOA in 18 patients who had suffered prehospital cardiac arrest and who were resuscitated by mobile intensive care unit paramedics employing an EOA. Arterial blood gas determinations were obtained during ventilation with the EOA and then repeated after endotracheal intubation. Arterial oxygen tension (PaO2) greater than 64 mm Hg was achieved in 11 of 12 patients who had been converted to supraventricular rhythm, despite varying inspired oxygen concentrations. A PaO2 greater than 77 mm Hg was achieved in three of six patients still requiring external cardiac massage. There was little or no improvement in oxygenation after endotracheal intubation, implying that the failures to oxygenate were not due to the EOA. We conclude that the EOA is a useful adjunct during cardiopulmonary resuscitation when endotracheal intubation is not feasible.