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To the Editor.—
I refer to the article on use of the EGTA in the prehospital setting. At first it seemed a convincing condemnation of EGTA use. However, a closer perusal revealed three problems.First, no one has yet addressed temporal changes in arterial blood gases (ABG) in the patient who has suffered full cardiopulmonary arrest. Ventilation-perfusion matching would be very poor at first, with widespread atelectasis. As proper resuscitation proceeds, it seems reasonable to assume that ABG values would improve as ventilation-perfusion matching improves. This uncontrolled variable could, therefore, account for some of the improvement that occurred when the patients were intubated.Second, in their discussion of results, the authors point out that only nine victims had ABG values within their criterion limits (Pao2≥80 mm Hg, Paco2 ≤55 mm Hg) when ventilated with EGTA. What they fail to point out is that after endotracheal intubation, 14
Fluck RR. Use of Esophageal Gastric Tube Airway. JAMA. 1984;252(2):209. doi:10.1001/jama.1984.03350020018012