A study throws doubt once again on the utility of cricoid pressure in preventing aspiration of gastric contents.
“The inclusion criteria were patients 18 years and older with a full stomach (<6 hours fasting) or the presence of at least 1 risk factor for pulmonary aspiration (emergency conditions, body mass index >30, previous gastric surgery [sleeve, bypass, or gastrectomy], ileus, early [<48 hours] postpartum, diabetic gastroparesia, gastroesophageal reflux, hiatus hernia, preoperative nausea/vomiting, and pain)”.
There was no difference in aspiration compared with a sham procedure but cricoid made intubation slower and more difficult. The authors caution that further study is needed in Obstetrics and outside the Operating Room.
However this study had a non-inferiority design that was underpowered with the low aspiration rates as well as defining a 50% difference threshold. It is unlikely to consign cricoid pressure to the history books but will perhaps confirm biases in the anti-cricoid camp!