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. 2025 Mar 22;14(7):2177.
doi: 10.3390/jcm14072177.

Practices of Rapid Sequence Induction for Prevention of Aspiration-An International Declarative Survey

Imen Ben-Naoui  1 , Vincent Compère  1 , Thomas Clavier  1   2 , Emmanuel Besnier  1   2
Affiliations

Practices of Rapid Sequence Induction for Prevention of Aspiration-An International Declarative Survey

Imen Ben-Naoui et al. J Clin Med. .

Abstract

Background/Objectives: Rapid sequence induction (RSI) for the prevention of aspiration is a frequent clinical situation during anesthesia. The lack of international guidelines on this topic may lead to differences in practices. The aim of this survey is to identify the clinical practices in RSI among practitioners at an international level. Methods: International declarative survey across the ESAIC network. Results: A total of 491 respondents in 61 countries, 74% of them were seniors and 42% with over 20 years of experience. Most of the practitioners (87%) performed preoxygenation under a high flow of oxygen (>10 L/min) with no PEEP and no pressure support and 69% use opioids in most cases of RSI. The Sellick maneuver was used by 42% of respondents. RSI was used in most situations at high risk of aspiration (bowel obstruction, trauma within 6 h after the last meal, caesarian section). RSI was used in 53% of cases of appendicectomy in the absence of vomiting. Conversely, 29% did not use RSI in cases of symptomatic esophageal reflux. A total of 11% encountered at least one episode of grade IV anaphylaxis to succinylcholine or rocuronium and 24% aspiration pneumonia. Conclusions: Our results support the need for international guidelines on RSI to limit differences between practitioners and countries.

Keywords: anesthesia; aspiration; pneumonia; rapid sequence induction and intubation; surveys and questionnaires.

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Conflict of interest statement

The authors declare no conflicts of interest.

References

    1. Fecho K., Moore C.G., Lunney A.T., Rock P., Norfleet E.A., Boysen P.G. Anesthesia-Related Perioperative Adverse Events during in-Patient and out-Patient Procedures. Int. J. Health Care Qual. Assur. 2008;21:396–412. doi: 10.1108/09526860810880207. - DOI - PubMed
    1. Morimatsu H., Accidental Event (Pulmonary Embolism) Working Group, Safety Committee of the Japanese Society of Anesthesiologists Incidence of Accidental Events during Anesthesia from 2012 to 2016: Survey on Anesthesia-Related Events by the Japanese Society of Anesthesiologists. J. Anesth. 2021;35:206–212. doi: 10.1007/s00540-021-02898-9. - DOI - PubMed
    1. Warner M.A., Meyerhoff K.L., Warner M.E., Posner K.L., Stephens L., Domino K.B. Pulmonary Aspiration of Gastric Contents: A Closed Claims Analysis. Anesthesiology. 2021;135:284–291. doi: 10.1097/ALN.0000000000003831. - DOI - PubMed
    1. Lienhart A., Auroy Y., Péquignot F., Benhamou D., Warszawski J., Bovet M., Jougla E. Survey of Anesthesia-Related Mortality in France. Anesthesiology. 2006;105:1087–1097. doi: 10.1097/00000542-200612000-00008. - DOI - PubMed
    1. Stept W.J., Safar P. Rapid Induction/Intubation for Prevention of Gastric-Content Aspiration. Anesth. Analg. 1970;49:633. - PubMed

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