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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Priebe HJ – Cricoid pressure: Compression of the cricoid cartilage.

In his original work, Sellick 2 recommends removal of the tube before anesthesia induction. However, this effect does not seem to cause gastroesophageal reflux Wilson NP – No pressure!

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

The Two Hands technique is an alternative for compression of the cricoid cartilage. Sellick maneuver is not a risk-free procedure.

Applying pressure on the cricoid cartilage increases the tonus of the upper esophageal sphincter 14but decreases the tonus of the lower esophageal sphincter 15suggesting the presence of mechanoreceptors in the pharynx that promote relaxation of this sphincter.

In some cases, visualization of the vocal cords is possible only after external manipulation of maniobta, such as the cricoid cartilage.

The technique involves the application of backward pressure on the cricoid cartilage with a force of newtons [4] to occlude the esophaguspreventing aspiration of gastric contents during induction of anesthesia and in resuscitation of emergency victims when intubation is delayed or not possible.

The proximal esophagus begins at the inferior portion of the cricoid cartilage. Ann Intern Med, ; Retrieved from ” https: Since then, the maneuver has been widely accepted by anesthesiologists as a fundamental step during induction with the rapid sequence technique.


Semin Anesth Maniobbra Med Pain, ; Besides being ineffective, compression of those structures can interfere with tracheal intubation or cause maniobea of the airways 1. However, during vomiting, when esophageal pressure can be higher than 60 cmH 2 O, the maneuver should be discontinued due to the risk of esophageal rupture. Thus, during anesthetic induction, while the patient is awake, 10 to 20 N should be applied, and 30 to 40 N when the patient is unconscious Int J Obst Anesth, ;2: Brock-Utne JG – Is cricoid pressure necessary?

Rev Bras Anestesiol, ; Textbook of Advanced Cardiac Life Support.

Cricoid pressure

They were placed in the supine position, lowering the torso slightly to avoid aspiration of regurgitated material.

Anaesth Intensive Care ; The authors observed the volume of air compressed by the plunger and transformed the values observed in measures of force. But according to some studies, Sellick maneuver hinders proper positioning of both devices 38, However, other investigators have found that cricoid pressure does not increase the rate of failed intubation. The aspects that have motivated some authors to abandon the Sellick maneuver during anesthetic induction with the rapid sequence technique are also discussed.

Cricoid pressure – Wikipedia

Many did not know the force applied or described it as “enough”, “enough force fe break an egg”, or “varies” Eur J Emerg Med, ; According to the author: How could pulmonary aspiration in cases that compression of the cricoid cartilage was applied be explained? Cricoid pressure should not be confused with the “BURP” Backwards Upwards Rightwards Pressure manoeuvre, which is used to improve the view of the glottis during laryngoscopy and tracheal intubationrather buurp to prevent regurgitation.

Vanner RG – Mechanisms of regurgitation and its prevents with cricoid pressure. Thus, the nasogastric tube provides safe passage of gastric contents when effective compression of the cricoid cartilage is applied.

Roewer N – Can pulmonary aspiration of gastric contents be prevented by burpp occlusion of the cardia? Cricoid pressurealso known as the Sellick manoeuvre or Sellick maneuveris a technique used in endotracheal intubation to try to reduce the risk of regurgitation. Clinical Anesthesia 6th ed. The cricoid cartilage and the oesophagus are not aligned in close to half of adult patients. To Do or Not Do”. Despite the importance of the Sellick maneuver in preventing pulmonary aspiration, it does not guarantee protection of the airways in all patients, especially when not used properly.


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Airway obstruction with cricoids pressure and lateral tilt. This association is a good option for the management of difficult airways in patients at risk for aspiration Endoscopic and radiological studies, as well as patients who presented pulmonary aspiration, despite the use of the Sellick maneuver, have raised doubts on the usefulness of the technique.

Assessing the force generated with the application of cricoid pressure. The initial proposal of cricoid maniorba 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.

By using this site, you agree to the Terms of Use and Privacy Policy. Despite the importance given to Sellick maneuver in preventing pulmonary aspiration, there are no guarantees it will protect the airways of all patients, especially se the technique is not properly used.

Cricoid pressure displaces the esophagus: How to cite this article. If visualization of the vocal cords with laryngoscopy or ventilation with a face fe is not adequate, one should reduce the force applied and reevaluate the place where pressure is being applied.

Landsman Budp – Cricoid pressure: