Correspondence  |   January 2018
Cricoid Pressure: Effective Measure or Ritual?
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Article Information
Correspondence
Correspondence   |   January 2018
Cricoid Pressure: Effective Measure or Ritual?
Anesthesiology 1 2018, Vol.128, 233-234. doi:10.1097/ALN.0000000000001951
Anesthesiology 1 2018, Vol.128, 233-234. doi:10.1097/ALN.0000000000001951
I read with great interest the review on cricoid pressure (CP) by Salem et al.1  The authors assure the reader that they have “used discretion in deciding which articles to finally include, favoring peer-reviewed articles from highly ranked journals written in English.” However, a couple of key references are missing, and a couple of publications require additional commenting to place the findings in the proper clinical perspective.
Although the authors cite those recent guidelines that indicate the common use of CP, they fail to cite those guidelines recently published by various national and international professional societies that no longer recommend routine application of CP. These include the 2010 Scandinavian Clinical Practice Guidelines on General Anesthesia for Emergency Situations,2  the 2015 Guideline on Airway Management released by the Board of the German Society of Anesthesiology and Intensive Care Medicine,3  and the 2015 European Resuscitation Council Guidelines for Resuscitation.4  Obviously, these guidelines reflect the doubt of the respective professional societies that the benefits of this technique outweigh its disadvantages. This may have considerable medicolegal implications, because a physician would no longer be blamed per se for not having applied CP. Based on findings of nonrandomized controlled trials, a recent Cochrane review concluded that CP may not be necessary to safely perform rapid sequence induction.5 
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