Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What is the major risk factor for increased gastrointestinal pressure during intubation?

1. Chronic lung disease

2. Intra-abdominal malignancies

3. Loss of protective reflexes

4. Obesity

The correct answer is: Loss of protective reflexes

The major risk factor for increased gastrointestinal pressure during intubation is associated with the loss of protective reflexes. When protective reflexes, such as the gag and swallow reflexes, are compromised—typically due to sedation, anesthesia, or neurological impairment—there is an increased risk of aspiration and potential regurgitation of gastric contents. This situation can lead to elevated gastrointestinal pressure, as the contents of the stomach may be displaced into the esophagus. In patients with lost protective reflexes, the ability to prevent foreign material from entering the airway is diminished. This lack of protective mechanisms during intubation can heighten the risk of aspiration, as well as cause associated complications, such as aspiration pneumonia, if gastrointestinal contents enter the trachea and lungs. Thus, understanding the implications of protective reflexes is critical for managing airways effectively during anesthetic procedures.