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There is no mention of gastric aspiration as some cardiac arrests have recently eaten .How often is this a problem severe enough to affect survival and neurological damage?
This was one of the most fascinating findings in both PART and AIRWAYS-2, aspiration rates were not significantly different between intubated patients and those managed with an EGD (iGel or King Laryngeal Tube). Historically, protection against aspiration has been one of the primary arguments for intubation. This equivalence is most likely because patients in cardiac arrest aspirated when they collapsed and during CPR, before EMS crews ever get to them to manage their airway.
In PART and Airways-2, rates of aspiration were similar between the groups. Bear in mind that aspiration is an entity that is difficult to define. For example, how do you detect aspirated vomit that was not visible in the oropharynx?
However, the Cardiac Arrest Airway Management (CAAM) study performed in France and Belgium (Jabre, et al., JAMA 2018) found higher rates of visible regurgitation with bag-valve-mask than endotracheal intubation in adult OHCAs. This supports the notion that intubation and supraglottic airways may in fact have this important benefit compared with BVM..
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