The esophageal obturator airway: an appraisal

The use of the Esophageal Obturator Airway (EOA) was prospectively studied in 300 cases of prehospital cardiac arrests. Seventy-seven complications were documented in 72 patients. Inadvertent tracheal intubation occurred in 72 patients. Inadvertent tracheal intubation occurred in 13 patients, five unrecognized. No differences were found when initial emergency room rhythm and resuscitation outcome were compared to a previous study using the oral airway (OA). A subgroup of 124 EOA and 55 OA patients were compared. The EOA was effective in reducing the frequency of aspiration (17 vs 34 per cent). Arterial oxygenation was similar, and rose in both groups following tracheal intubation. Esophageal trauma was found in 10 per cent of the EOA patients who underwent autopsy. Although the EOA is useful in prehospital emergency care, the only advantage for this technique in comparison to the OA is the prevention of aspiration of gastric contents. It also appears that other techniques of advanced cardiac life support, i.e. defibrillation, drug therapy, etc. are necessary to improve survival statistics.