The Efficacy of Cricoid Pressure in Preventing Regurgitation of Gastric Contents

Fanning, Gary L.

doi:10.1097/00000542-197006000-00019

Cited by 92 publications

(23 citation statements)

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“…Fanning postulated an esophageal pressure of more than 60 cm H 2 O during vomiting by analyzing cricoid pressure during intubation. 6 Brimacombe and Keller described a patient vomiting through a ProSeal LMA over a distance of 1.2 m and postulated after simulation in a model that the esophageal pressure was 105 cm H 2 O. 7 Our maximum pressure of 130 cm H 2 O might be substantially higher 8 -10 Other studies in model systems have resulted in similar conclusions.…”

Section: Discussionmentioning

confidence: 80%

A Comparison of Seal in Seven Supraglottic Airway Devices Using a Cadaver Model of Elevated Esophageal Pressure

Bercker

Schmidbauer²,

Volk³

et al. 2008

Anesthesia &Amp; Analgesia

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Section: Discussionmentioning

confidence: 80%

A Comparison of Seal in Seven Supraglottic Airway Devices Using a Cadaver Model of Elevated Esophageal Pressure

Bercker

Schmidbauer²,

Volk³

et al. 2008

Anesthesia &Amp; Analgesia

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“…Esophageal pressure during vomiting or regurgitation was postulated to be 60 to 105 cmH 2 O, although it has not been extensively studied. [24,25] To simulate a more clinically urgent situation in terms of the occurrence of pulmonary aspiration, we used an esophageal pressure of 130 cmH 2 O, which was equal to that used by Bercker et al [26] In summary, prevention of aspiration of gastric contents was diffi cult in the semi-lateral position within clinically relevant ranges when placing the head in the neutral, simple extension, and sniffing positions. The lateral or excessive semi-lateral position was necessary to protect the trachea and lung from aspiration.…”

Section: Discussionmentioning

confidence: 99%

Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions

Takenaka

Aoyama²

2016

World Journal of Emergency Medicine

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BACKGROUND: Pulmonary aspiration of gastric contents during tracheal intubation is a lifethreatening complication in emergency patients. Rapid sequence intubation is commonly performed to prevent aspiration but is not associated with low risk of intubation related complications. Although it has been considered that aspiration can be prevented in the lateral position, few studies have evaluated the ability to prevent aspiration. Moreover, this position is not always a favorable position for tracheal intubation. If aspiration can be prevented in a clinically relevant semi-lateral position, it may be advantageous. We assessed the ability to prevent aspiration in the lateral position and various degrees of the semi-lateral position using a vomiting-regurgitation manikin model. METHODS:A manikin's head was placed in the neutral, simple extension, or sniffing position. The amount of aspirated saline into the bronchi during simulated vomiting was measured at semilateral position angles of 0º to 90º in 10º increments. The difference in the vertical height between the mouth corner and the inferior border of the vocal cord was measured radiologically at each semilateral position in the three head-neck positions.RESULTS: Pulmonary aspiration was prevented at the ≥70º, ≥80º, and 90º semi-lateral positions in the neutral, simple extension, and sniffi ng positions, respectively. The mouth was lower than the vocal cord in the semi-lateral position in which aspiration was prevented. CONCLUSION:The lateral or excessive semi-lateral position was necessary to protect the lung from aspiration in the head-neck positions commonly used for tracheal intubation. Prevention of aspiration was diffi cult within clinically relevant semi-lateral positions.

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“…[13] On application of cricoid pressure esophagus gets compressed was the finding of cadaveric study by Fanning in 1970. [14] In 2009 under magnetic resonance imaging studies, Rice et al found that on application of cricoid pressure hypopharynx is compressed and not the esophagus. On compression of cricoid ring, hypopharynx is occluded even if the cricoid ring is lateral to vertebral body.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Pulmonary Aspiration and Sellick ’ S Maneuver in Emergency Lap a Rotomies

Subhedar¹,

Shelke²,

Patel³

2015

jemds

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The Efficacy of Cricoid Pressure in Preventing Regurgitation of Gastric Contents

Cited by 92 publications

References 0 publications

A Comparison of Seal in Seven Supraglottic Airway Devices Using a Cadaver Model of Elevated Esophageal Pressure

A Comparison of Seal in Seven Supraglottic Airway Devices Using a Cadaver Model of Elevated Esophageal Pressure

Prevention of aspiration of gastric contents during attempt in tracheal intubation in the semi-lateral and lateral positions

Evaluation of Pulmonary Aspiration and Sellick ’ S Maneuver in Emergency Lap a Rotomies

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