Inflation pressure, gastric insufflation and rapid sequence induction

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Emergency Medicine

Background:

• Gastric insufflation during manual ventilation is a potential complication.
• Understanding factors influencing gastric insufflation is crucial for patient safety.

Purpose of the Study:

• To investigate the relationship between lung inflation pressures and airway pressures required for gastric insufflation during manual ventilation.
• To assess the impact of cricoid pressure on gastric insufflation during rapid sequence induction.

Main Methods:

• Manual ventilation with a mask was performed.
• Inflation pressures and airway pressures were monitored.
• The effect of cricoid pressure was evaluated.

Main Results:

• Satisfactory lung ventilation without gastric insufflation was achieved in all patients with gentle manual ventilation.
• Gastric insufflation occurred in 50% of patients when maximal inflation pressures were applied without cricoid pressure.
• No gastric insufflation was observed in any patient with a patent airway when cricoid pressure was applied.

Conclusions:

• Gentle manual ventilation effectively prevents gastric insufflation.
• High inflation pressures increase the risk of gastric insufflation.
• Cricoid pressure effectively prevents gastric insufflation in patients with a patent airway.