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British Journal of Anaesthesia 2004 93(4):497-500; doi:10.1093/bja/aeh234
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2004

Editorial II: Who is at increased risk of pulmonary aspiration?

T. Asai

Department of Anaesthesiology, Kansai Medical University, 10-15 Fumizono-cho, Moriguchi City, Osaka, 570-8507, Japan

E-mail: asait@takii.kmu.ac.jp

The first 150 words of the full text of this article appear below.

Since the danger of pulmonary aspiration was recognized in the 1930s in obstetric anaesthesia,1 and Mendelson established its aetiology in 1946,2 efforts have been made to reduce its incidence: fasting before anaesthesia, prophylactic medication (such as antacids or H2 antagonists), rapid-sequence induction of anaesthesia with application of cricoid pressure, and the use of a cuffed tracheal tube.

The laryngeal mask airway has gained a firm place in anaesthetic practice since it was made available to clinicians in 1988. The frequency of tracheal intubation has been decreasing, because of routine use of the laryngeal mask airway and several other supraglottic airways (such as the Laryngeal Tube or Airway Management Device). Nevertheless, there has been ongoing concern that avoidance of the use of a cuffed tracheal tube might increase the incidence of pulmonary aspiration.3 Some consider that spontaneous breathing should be maintained when the laryngeal mask is used, because intermittent positive pressure . . . [Full Text of this Article]

Predisposing factors

Patient factors

Operation factors

Anaesthesia factors

Device factors

Variability in the material aspirated

Do we really know who are at risk?

What we should do?


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