Dr. Michael Steuerwald and Dr. Darren Braude recently worked together on Preliminary Report Comparing Aspiration Rates for Endotracheal Intubation and Extraglottic Devices. Published in the July-August issue of Air Medical Journal, the two hope that their work can open the door for new research on the topic.
“Historically people have been more comfortable with intubation,” says Dr. Braude. “I think that this is one of a few papers now that challenge conventional notions and I hope that this helps support people who are already managing airways, or thinking of managing airways this way, and gives them some small amount of reassurance that this is a reasonable approach.”
In their research, they looked at 67 prehospital patients with extraglottic devices and 94 that were intubated. In their findings, they saw that aspiration rates were not statistically different.
“This was a small study,” Dr. Braude adds. “It does not definitively answer any questions, it’s a quality assurance study. But it should generate ideas for other research, and challenge other standards.”
This study follows others that hint at the same conclusion. Dr. Braude referenced two recent papers that together included over 10,000 cardiac arrest patients, that also saw no significant difference in aspiration rates between the two methods (JAMA 2018 Aug 28; 320:769 and JAMA 2018 Aug 28; 320:779) . While cardiac arrest patients are an isolated group, this research still aligns with the findings of Dr. Braude and Dr. Steuerwald.
Dr. Braude would like to see an expansion on this study, and to focus on new concepts within it.
“I would like to be able to look at a larger number of patients so that we could also try to see if this pattern holds up in a larger number of people,” he says. “Or if there is a difference between specific extraglottic devices, because we haven’t looked at that yet.”