Hankins D G, Carruthers N, Frascone R J, Long L A, Campion B C
Division of Emergency Medical Services, Mayo Clinic, Rochester, Minn. 55905.
Prehosp Disaster Med. 1993 Apr-Jun;8(2):117-21. doi: 10.1017/s1049023x00040176.
The purpose of this study was to determine the complication rates associated with the use of the endotracheal tube (ET) and the use of the esophageal obturator airway/esophageal gastric tube airway (EOA/EGTA) during the treatment of patients with prehospital cardiac arrest.
A descriptive, quasi-experimental study of 509 consecutive adults, cardiac arrest patients was conducted. Patients were examined prospectively for airway intervention type and complications. Some patients were examined at their final destinations (field, morgue, funeral home), while other patients were examined by EMS providers in the field when airway adjuncts were switched. Also, airways were evaluated for complications by emergency physicians at destination emergency departments.
The airway in use at the time of examination was the esophageal obturator airway (EOA) or esophageal gastric tube airway (EGTA) in 208 patients (40.1%); the ET (endotracheal tube) in 232 patients (45.6%); and an oral or nasopharyngeal airway in 47 patients (9.2%). Twenty-two patients (4.3%) had both an EOA/EGTA and an ET tube in place at the time of the examination. The survival rates were similar between the EOA/EGTA and the ET groups (28% and 32%, respectively). The complication rates overall also were similar, but the serious or potentially lethal complication rate was 3.3 times more common with the use of the EOA/EGTA than with the ET tube (8.7% versus 2.6%, respectively).
The complication rate for the EOA/EGTA is unacceptably high, and careful thought must be given to its continued use.(ABSTRACT TRUNCATED AT 250 WORDS)
本研究旨在确定在院外心脏骤停患者治疗过程中，使用气管内导管（ET）以及食管阻塞气道/食管胃管气道（EOA/EGTA）的并发症发生率。
对509例连续的成年心脏骤停患者进行了一项描述性、准实验性研究。对患者进行前瞻性气道干预类型及并发症检查。部分患者在其最终目的地（现场、停尸房、殡仪馆）接受检查，而其他患者在气道辅助设备更换时由急救医疗服务人员在现场进行检查。此外，目的地急诊科的急诊医生对气道并发症进行评估。
检查时正在使用的气道，208例患者（40.1%）为食管阻塞气道（EOA）或食管胃管气道（EGTA）；232例患者（45.6%）为气管内导管（ET）；47例患者（9.2%）为口咽或鼻咽气道。22例患者（4.3%）在检查时同时使用了EOA/EGTA和ET管。EOA/EGTA组和ET组的生存率相似（分别为28%和32%）。总体并发症发生率也相似，但使用EOA/EGTA时严重或潜在致命并发症发生率是使用ET管时的3.3倍（分别为8.7%和2.6%）。
EOA/EGTA的并发症发生率高得令人无法接受，必须慎重考虑是否继续使用。（摘要截选至250词）
