Emergency intubation with the combitube®: Comparison with the endotracheal airway

Study objective: To evaluate the safety and effectiveness of the Combitube(R) as used by ICU nurses under medical supervision compared with endotracheal airway established by ICU physicians during CPR. Design: Prospective study of ICU patients over a seven-month period. Setting: Medical ICU. Participants: Thirty-seven patients suffering from cardiac arrest. Interventions: Emergency intubation with either the Combitube(R) by nurses.or the endotracheal airway by physicians and subsequent mechanical ventilation. Measurements and main results: Evaluation of blood gases after 20 minutes of mechanical ventilation. Intubation time was shorter for the Combitube(R) (P<.001). Blood gases for each device showed comparable results; PaO2 was slightly higher during ventilation with the Combitube(R) (P<.001). Conclusion: The Combitube(R) as used by ICU nurses was as effective as establishment of the endotracheal airway by intensivists during CPR. The Combitube(R) may be used whenever endotracheal intubation cannot be performed immediately.