What intervention may increase the risk of aspiration pneumonitis?

Maintaining peak airway pressures of 35 cm H2O can increase the risk of aspiration pneumonitis because elevated airway pressures may lead to difficulty in controlling ventilation and can result in impaired airway protection. When peak airway pressures are high, it can indicate that negative pressure is being applied to the airway, which could encourage the influx of gastric contents into the tracheobronchial tree if regurgitation occurs. This inappropriate ventilation technique can compromise airway reflexes, making aspiration more likely.

In contrast, the application of cricoid pressure is a technique aimed at preventing regurgitation during intubation. The use of gastroprokinetic agents is intended to decrease gastric volume and increase gastric emptying, reducing the risk of aspiration. Administering sodium citrate is a preventive measure that alkalinizes gastric contents, also helping to minimize damage in case of aspiration. Each of these other interventions has protective mechanisms that help to lower the risk of aspiration, unlike maintaining elevated airway pressures.