La maniobra de Sellick o presión cricoidea es un procedimiento que se . D.D. Snider, D. Clarke, B.T. FinucaneThe “BURP” maneuver worsens the glotic view. Emergencias_9_6_pdf. VENTAJAS DE LA MANIOBRA BURP FRENTE A LA MANIOBRA DE SELLICK EN LA INTUACIÓN DIFÍCIL. 53 KB. Estudio sobre la eficacia clínica de la maniobra B.U.R.P. en la intubación orotraqueal (IOT) bajo laringoscopia directa (LD). Grijalba LA, Alcibar JL, Calvo López.

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The proximal esophagus begins at the inferior portion of the cricoid cartilage. Canadian Journal of Anesthesia.

The indications, technique, and complications of compression of the cricoid cartilage were reviewed. Flexion of the head induced by the force applied indirectly on the cervical spine, decreasing visualization of the glottis, is one of the disadvantages of this maneuver 9.

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From the decade of on, studies on compression of the cricoid cartilage started focusing on the force that should be applied and not on gastric pressure. Answers varied from 1 to 44N, for awake patients, and 2 to ce N, for unconscious patients.

A study with a new nasogastric tube.

The technique involves the application of backward pressure on the cricoid cartilage with a force of newtons [4] to occlude the bufppreventing aspiration of gastric contents during induction of anesthesia and in resuscitation of emergency victims when intubation is delayed or dee possible. Landsman I – Cricoid pressure: Cheney FW – Aspiration: An additional benefit of cricoid pressure occurs in paralyzed patients in whom gastric insufflation occurs at lower inflation pressures.


In Brian Arthur Sellick —an anaesthetistpublished the paper Cricoid pressure to control regurgitation of stomach contents during induction of anesthesia—preliminary communicationdescribing the application of cricoid pressure for the prevention of regurgitation.

Vanner RG – Mechanisms of regurgitation and its prevents with cricoid pressure.

The objective of this configuration is to control the lateral movement of the cartilage 2. Learning to apply effective cricoid pressure using a part task trainer.

Cricoid pressure – Wikipedia

Besides, when not used properly, it can cause deformity of the cartilage, closure of the vocal cords, and difficulty ventilating. The initial proposal of cricoid pressure as a useful clinical procedure, its subsequent adoption as the lynchpin of patient safety, and its current decline into disfavor represents a classic example of the need for evidence-based medicineand the evolution of medical practice.

Ann Intern Med, ; The technique is similar for adults and children, except by the reduced size and the more cephalad placement of the cricoid cartilage in younger patients 1.

It does not seem to be significant differences in the incidence of pulmonary aspiration when different sizes of nasogastric tube are used Anatomical variation of the airways among the individuals evaluated might explain the different results.

The technique is also important in possibly preventing insufflation of gas into the stomach. InSellick described the importance of applying pressure on the cricoid cartilage to prevent regurgitation of gastric contents during induction of anesthesia.

Compression of the cricoid cartilage: current aspects

This is the only cartilaginous structure of the upper airways whose format represents a complete ring. When the difficult to manage airways is only noticed after general ce induction, ventilation with a face mask would be recommended immediately, but one should be careful with the patient on a full stomach. The model was considered an effective training, but the duration of the ability acquired decreased significantly after one month. The bur applied on the cricoid cartilage should be enough to occlude the esophagus, without obstructing or hindering ventilation.


Cricoid pressure

Cricoid pressure may also compress the glottis, which can obstruct the view of the laryngoscopist and actually cause a delay in securing the airway. According to the authors, cardiovascular changes were similar to those observed during tracheal intubation in awake patients. According to Kopka and Robinson 27the mL syringe is an effective training model, even when applied immediately before using the Sellick maneuver. The effect of cricoids pressure on the cricoids cartilage and vocal cords: In awake individuals, applying more than 20 N on the cricoid cartilage can cause pain, cough and nausea.

Int J Obst Anesth, ;2: Besides, knowledge of the force to be applied, acquired through training in mechanical models, decreased with time. Cricoid pressure displaces the esophagus: Prevention of pulmonary aspiration is fundamental, but permeability of the airways is more important.

Many did not know the force applied or described it as “enough”, “enough force to break an egg”, or “varies” Brock-Utne JG – Is cricoid pressure necessary?