Anaes Cases · Aspiration & regurgitation
The cricoid pressure — the contemporary evidence
The short case — the cricoid pressure and the Birenbaum RCT. The standard for the decades; the no-significant-reduction of the aspiration (the Birenbaum); the limitations (the misapplication, the impeded intubation); the modern modified-cricoid and the no-cricoid options.
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Prompt
A trainee asks whether the cricoid pressure is still needed in the RSI, given the recent evidence. Explain the modern position.
Presentation
A trainee asks: "The cricoid pressure was the standard of the RSI for the decades, but I have heard the recent evidence challenges it. Do we still need the cricoid in the RSI?" Explain the modern position.
[4]References2ShowHide
- [4]Birenbaum A, et al. Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial. JAMA Surg, 2019.PMID 30347104
- [1]Sorbello M, et al. Pharmacological approach to rapid sequence induction: a contemporary review. Curr Opin Anaesthesiol, 2025.PMID 40493782