Intubation Intraesophageal, Respiratory Aspiration of Gastric Contents
Conditions
Keywords
Intubation, Sellick´s maneuver, aspiration, [E05.497.578]
Brief summary
The goal of this study is to evaluate the effect of Sellick´s Maneuver, a firm pressure on the throat, just below the Adams apple, to occlude the esophagus, in order to prevent aspiration of gastric contents, on intubation with a flexible fiberscope. The result of this study will be participate in the discussion of the importance of Sellick´s Maneuver.
Detailed description
The patients included in this study has volunteered after sufficient information, and must be ASA-class I-II, 18 years or more, and must not have indications for a rapid sequence induction. The patient will be intubated twice, with and without Sellick´s maneuver. It is blinded to the intubating physician, in which order this pressure is applied. The outcomes measures will be time of intubation, oxygen saturation before and after intubation and a Cormack Scale graduation of the visibility of the vocal cords. The intubation will be failed, if it cannot be performed under 120 seconds, or if the patients desaturate to 95% or less.
Interventions
PROCEDUREApplication of Sellick´s maneuver.
The patient will be intubated with a flexible fiberscope, Olympus model, under the application of Sellick´s maneuver, with the recommended 30 Newtons pressure, and also, as control, be intubated with a sham Sellick´s maneuver, with 0 Newton. The order of the pressures is randomized, and it is blinded to the intubating physician by a cloth which of the maneuvers that is used. The pressure is measured be a pediatric cuff, which is pressed against the throat.
Sponsors
Glostrup University Hospital, Copenhagen
Study design
Observational model
CASE_CROSSOVER
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* ASA I-II * Informed consent to participate in the study * Age 18 or older * Predicted difficult airways
Exclusion criteria
* Body mass index more then 35 * Patients with an indication for a rapid sequence induction (reflux, Hiatus herniation, Gastric bypass)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time of intubation | 180 seconds | The investigators will find an eventually change in the time of intubation with and without Sellick´s Maneuver |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of patients that cannot be intubated after 120 sec. with and without Sellick´s maneuver | 180 seconds | Patients that is not intubated after 120 seconds in each trial, will count as not intubated after 120 seconds. |
| Fall of oxygen saturation after intubation with and without Sellick´s maneuver. | 180 seconds | The investigators measure the oxygen saturation on a finger device at the beginning and the and of the intubations. |
| Visualization of the vocal cords | 180 seconds | The investigators will observe the visualization of the vocal cords, and provide the result on the Cormack Score. |
Countries
Denmark
Outcome results
None listed