Acid Aspiration Syndrome

Farman, Jean

doi:10.1177/175045890401400603

Cited by 10 publications

(16 citation statements)

References 17 publications

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“…AAS occurs when > 25 ml gastric fluid with pH < 2.5 is aspirated. Situations that predispose to this are: not fasting before induction, 'light' anaesthesia, pre-existing conditions such as hiatus hernia or conditions likely to result in increased intra-abdominal pressures such as pregnancy, obesity, ascites, bowel obstructions or other concurrent serious illnesses [1,2]. Whilst AAS is rare, the morbidity and mortality associated with it justifies seeking preventive measures.…”

mentioning

confidence: 99%

The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta‐analysis of randomised control trials

et al. 2009

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SummaryAspiration of acid into the lungs is an infrequent but potentially devastating complication of general anaesthesia. Routine practice often includes use of pharmacological agents to reduce gastric volume and increase gastric pH. The aim of this study was to compare the net benefit of proton pump inhibitors with histamine 2 blockers in a meta-analysis. Electronic databases were searched for trials that compared ranitidine vs proton pump inhibitors in their effect on volume and pH of gastric fluid aspirates. We identified nine trials of which seven were suitable for meta-analysis. Pooled outcomes suggest that premedication with ranitidine is more effective than proton pump inhibitors in reducing the volume of gastric secretions (by an average of 0.22 ml.kg ; 95% confidence interval 0.04-0.41) and increasing gastric pH (by an average of 0.85 pH units; 95% confidence interval )1.14 to )0.28).

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mentioning

confidence: 99%

The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta‐analysis of randomised control trials

et al. 2009

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“…The alfentanil and the remifentanil have a faster beginning of action and seem to diminish the response to the laryngoscopy and intubation. In healthy patients, alfentanil (30 µg.kg -1 ) almost completely weakened their response to the manipulation of the airways [1][2][3][15][16][17] . Possibly, the choice of fentanyl among anesthesiologists of the HSP is due to the medication being broadly available in the Brazilian market, having a low cost and being relatively well known by the doctors.…”

Section: Discussionmentioning

confidence: 96%

Avaliação da técnica de indução em sequência rápida dos anestesiologistas de um hospital universitário

Guirro¹,

Martins²,

Munechika³

2012

Rev. Bras. Anestesiol.

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Background and objectives:The induction of the general anesthesia in patients on "a full stomach" can result in regurgitation of the gastric content and pulmonary aspiration. The function of the rapid sequence induction (RSI) is to minimize the time interval between the loss of the airway protection reflexes and tracheal intubation tube balloon. The objective of this study was to evaluate the rapid sequence induction among the anesthesiologists of the São Paulo Hospital. Methods:The participants answered the questionnaire voluntarily and anonymously, after signed consent. The questionnaire consisted of 60 questions about the fundamental points of the RSI. The questions were divided in pre-oxygenation, circuits, drugs used in the induction (opioids, hypnotics, neuromuscular blockers), cricoid pressure techniques, intubation and difficult intubation.Results: Seventy-five questionnaires were applied and 22 were discarded due to incomplete answering. All anesthesiologists always declare doing pre-oxygenation and administering opioid, hypnotic, and neuromuscular blocker. Most use fentanyl (83%), propofol (74.5%) and succinylcoline (68.6%). All anesthesiologists apply cricoid pressure. Most did not know the correct pressure to be applied on the cricoid cartilage. Intubation failures have already occurred with 71.7% of anesthesiologists and with 40%, the regurgitation. When faced with an unexpected difficult intubation, anesthesiologists ask for the laryngeal mask (35.5%). Conclusions:This study showed a broad individual variety of the RSI technique, a fact already reported by different authors. The difficulty in establishing a RSI protocol can be attributed to constant evidence that science provides us, where updating over the years becomes good medical practice .

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“…As the patient loses consciousness, greater cricoid pressure is applied and tracheal intubation quickly completed. This technique is widely used in emergency and obstetric anaesthesia when gastric emptying cannot be guaranteed prior to anaesthesia; examples include patients in trauma, those with intestinal obstruction, obstetric patients and patients with hiatus hernia (Farman, 2004).…”

Section: Literature Review Methodsmentioning

confidence: 99%

“…Failure to exert the correct degree of pressure on the cricoid cartilage has significant implications for the patient, as anaesthetic drugs causes a loss of reflexes, thus predisposing the patient to acid aspiration (Farman, 2004). This passive process can occur unnoticed by the anaesthetist or anaesthetic nurse, and an unconscious patient aspirating a relatively small amount of gastric content (∼25 mL) can develop serious complications either perioperatively or postoperatively (Patten, 2006).…”

Section: Literature Review Methodsmentioning

confidence: 99%

Teaching anaesthetic nurses optimal force for effective cricoid pressure: a literature review

Parry

2009

Nursing in Critical Care

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Acid Aspiration Syndrome

Cited by 10 publications

References 17 publications

The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta‐analysis of randomised control trials

The effect of ranitidine versus proton pump inhibitors on gastric secretions: a meta‐analysis of randomised control trials

Avaliação da técnica de indução em sequência rápida dos anestesiologistas de um hospital universitário

Teaching anaesthetic nurses optimal force for effective cricoid pressure: a literature review

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