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Comment & Response
February 27, 2019

Utility of Cricoid Pressure—Reply

Author Affiliations
  • 1Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, Assistance Publique–Hôpitaux de Paris, Paris, France
  • 2Department of Biostatics, Pitié-Salpêtrière Hospital, Assistance Publique–Hôpitaux de Paris, Sorbonne Université, Paris, France
  • 3Department of Emergency Medicine and Surgery, Pitié-Salpêtrière Hospital, Assistance Publique–Hôpitaux de Paris, Sorbonne Université, Paris, France
JAMA Surg. 2019;154(6):564-565. doi:10.1001/jamasurg.2018.5851

In Reply We thank our colleagues for the opportunity to elaborate on our findings.1 One-handed cricoid pressure (CP) was applied in our trial. There is no evidence that bimanual pressure is better.2 Khorasani et al said that our study was not sufficiently powered, but this hypothesis was clearly discussed in the Discussion section.1 However, when looking at all end points, we also failed to observe any positive signals in favor of CP, making calculation of the number of patients needed for future trials difficult. To our knowledge, this is the largest clinical trial on CP, and we think that future recommendations should take it into account. If CP were to be invented today, a superiority trial would be required to adopt it. We have not demonstrated noninferiority but the previous literature has also failed to demonstrate a clear benefit of CP.

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