Document Detail


Laryngopharyngeal pH measurement.
MedLine Citation:
PMID:  15208239     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Most emergency department (ED) intubations are to prevent gastric contents aspiration. The incidence of aspiration is unknown and intubation has complications. Balancing these risks requires an idea of the incidence of aspiration. This study assessed one technique for investigating the aspiration risk in ED patients. Cricoid pressure is used to reduce this risk and the technique may also examine this manoeuvre. METHODS: Cohorts of unconscious adult ED and elective surgical patients were recruited. The posterior pharyngeal wall pH was measured immediately before and after intubation. Pharyngeal pH was used to indicate risk of aspiration, and pH change to assess the efficacy of cricoid pressure. RESULTS: Eight ED and 48 control patients were recruited. In the ED cohort, pH ranged from 6.0 to 8.0 before intubation and 4.7 to 8.0 after intubation: a mean decrease of 0.3 (95% CI 1.5 decrease to 0.9 increase). In the control cohort pH ranged from 5.8 to 8.0 before intubation and 6.0 to 8.0 after intubation: a mean increase of 0.4 (95% CI 0.1 to 0.6 increase). CONCLUSIONS: This is a simple, cheap, and repeatable technique for assessing aspiration risk in emergency intubations. A larger study is required to assess the efficacy of cricoid pressure.
Authors:
E J Spurrier; M J Clancy; C D Deakin
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Emergency medicine journal : EMJ     Volume:  21     ISSN:  1472-0213     ISO Abbreviation:  Emerg Med J     Publication Date:  2004 Jul 
Date Detail:
Created Date:  2004-06-21     Completed Date:  2005-02-22     Revised Date:  2008-11-20    
Medline Journal Info:
Nlm Unique ID:  100963089     Medline TA:  Emerg Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  493-4     Citation Subset:  IM    
Affiliation:
School of Medicine, Southampton University School of Medicine, Southampton General Hospital, Tremona Road, Southampton SO16 6YD, UK. babydoc@edspurrier.co.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cricoid Cartilage
Female
Humans
Hydrogen-Ion Concentration
Hypopharynx / metabolism*
Intubation, Intratracheal / adverse effects*
Male
Middle Aged
Pilot Projects
Pneumonia, Aspiration / diagnosis*,  etiology*,  prevention & control
Pressure
Reagent Strips
Chemical
Reg. No./Substance:
0/Reagent Strips

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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