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Laryngopharyngeal pH measurement
E J Spurrier1, M J Clancy, C D Deakin
1School of Medicine, Southampton University School of Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK. babydoc@edspurrier.co.uk
Emergency Medicine Journal : EMJ
|June 23, 2004
Summary
This study introduces a simple method to assess aspiration risk during emergency intubations. Measuring pharyngeal pH helps evaluate the risk of aspiration and the effectiveness of cricoid pressure.
Area of Science:
- Emergency medicine
- Anesthesiology
- Critical care
Background:
- Emergency department (ED) intubations aim to prevent aspiration of gastric contents.
- The actual incidence of aspiration and the complications of intubation are not well-defined.
- Accurate risk assessment is crucial for balancing the benefits and risks of ED intubation.
Purpose of the Study:
- To evaluate a novel technique for assessing aspiration risk in emergency intubation patients.
- To investigate the potential of this technique in examining the efficacy of cricoid pressure during intubation.
Main Methods:
- Recruited unconscious adult patients from ED and elective surgery settings.
- Measured posterior pharyngeal wall pH immediately before and after endotracheal intubation.
- Utilized pharyngeal pH changes to indicate aspiration risk and assess cricoid pressure effectiveness.
Main Results:
- Eight ED patients and 48 control patients were included.
- ED cohort showed a mean pharyngeal pH decrease of 0.3 post-intubation (pH 4.7-8.0).
- Control cohort demonstrated a mean pharyngeal pH increase of 0.4 post-intubation (pH 6.0-8.0).
Conclusions:
- The described technique is simple, cost-effective, and repeatable for assessing aspiration risk in emergency intubations.
- Further research with a larger cohort is necessary to definitively assess the efficacy of cricoid pressure.