Airway obstruction with cricoid pressure and lateral tilt

✍ Scribed by G. Hocking; F. L. Roberts; M. E. Thew

• Book ID: 104456730
• Publisher: John Wiley and Sons
• Year: 2001
• Tongue: English
• Weight: 155 KB
• Volume: 56
• Category: Article
• ISSN: 0003-2409
• DOI: 10.1046/j.1365-2044.2001.02133.x

✦ Synopsis

We studied the effect of cricoid pressure and lateral tilt on airway patency during ventilation by facemask in a simulated obstetric setting. The lungs of 50 patients were ventilated by facemask and Guedel airway using a Nuffield Penlon 200 ventilator and Bain system with standard settings. Expired tidal volumes and peak inspiratory pressures were recorded for 10 breaths in each of four combinations: supine with no cricoid pressure, supine with cricoid pressure, 15° lateral tilt with no cricoid pressure and 15° lateral tilt with cricoid pressure. The timing of cricoid pressure was randomised and blinded to all observers. In both supine and tilted positions, cricoid pressure produced a reduction in tidal volume (p < 0.001) and an increase in peak inspiratory pressure (p < 0.001). Cricoid pressure with lateral tilt did not produce any additional airway obstruction to that in the supine position. Complete airway obstruction (tidal volume < 200 ml) resulted on three occasions, all with cricoid pressure applied.