Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.07.008
Brazilian Journal of Anesthesiology
Clinical Research

Reinforcing the valuable role of gastric ultrasound for volume and content assessment: an observational study

Elena Segura-Grau; Ana Segura-Grau; Ricardo Araújo; Guillermo Payeras; Jorge Cabral; Vera Afreixo

Downloads: 0
Views: 18

Abstract

Background
Pulmonary aspiration is one of the most important complications in anesthesiology. Assessment of gastric content by ultrasound is a good method to quantify gastric volume and to determine the risk of intraoperative pulmonary aspiration. The aim of this study is to determine the accuracy of the gastric ultrasonography in the qualitative analysis of gastric content, mainly in the analysis of small amounts of liquid content.

Methods
Gastric ultrasound was performed to 36 patients before upper gastrointestinal endoscopy (UGI), making two longitudinal scans at the epigastric level, one in supine position and the other in right lateral decubitus position, measuring two diameters and the area of the gastric antrum and assessing the content characteristics determining whether it was an empty stomach or contained fluid or solid content. Subsequently, the ultrasound findings were compared with UGI findings.

Results
Gastric areas were analyzed by the trace and the lengths of the craniocaudal and anteroposterior axes concluding that there are no significant differences between the two methods. No statistically significant difference was found between UGI and US assessment technics. No statistically significant difference was found between the estimated volume by UGI and US.

Conclusions
Though our study has some limitations, qualitative analysis of gastric content using ultrasound followed by endoscopy enabled the conclusion that there are no differences in the qualitative assessment regarding these two techniques, supporting the important role of point-of-care gastric ultrasound (POCGUS) in the assessment of pulmonary aspiration risk by the anesthesiologist in the perioperative period.

Keywords

Gastric antrum;  Pulmonary aspiration;  Gastric ultrasound;  Point of care ultrasound;  Gastric volume

References

1 K.S. Nason Acute Intraoperative Pulmonary Aspiration Thorac Surg Clin., 25 (2015), pp. 301-307

2 A. Lienhart, Y. Auroy, F. Péquignot, et al. Survey of anesthesia-related mortality in France Anesthesiology., 105 (2006), pp. 1087-1097

3 A. Perlas, V.W. Chan, C.M. Lupu, et al. Ultrasound Assessment of Gastric Content and Volume Anesthesiology., 111 (2009), pp. 82-89

4 P. Van de Putte, A. Perlas Ultrasound assessment of gastric content and volume Br J Anaesth., 113 (2014), pp. 12-22

5 A. Perlas, N. Mitsakakis, L. Liu, et al. Validation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination Anesth Analg., 116 (2013), pp. 357-363

6 L. Bouvet, J.X. Mazoit, D. Chassard, et al. Clinical assessment of the ultrasonographic measurement of antral area for estimating preoperative gastric content and volume Anesthesiology., 114 (2011), pp. 1086-1092

7 L. Bolondi, M. Bortolotti, V. Santi, et al. Measurement of gastric emptying time by real-time ultrasonography Gastroenterology., 89 (1985), pp. 752-759

8 A. Kaydu, E. Gokcek Sonographic gastric content evaluation in patients undergoing cataract surgery Niger J Clin Pract., 22 (2019), pp. 1483-1488

9 P. Van de Putte, L. Vernieuwe, A. Jerjir, et al. When fasted is not empty: a retrospective cohort study of gastric content in fasted surgical patients Br J Anaesth., 118 (2017), pp. 363-371

10 M. Sugita, M. Matsumoto, Y. Tsukano, et al. Gastric emptying time after breakfast in healthy adult volunteers using ultrasonography J Anesth., 33 (2019), pp. 697-700

11 S. Sharma, S.A. Deo, P. Raman Effectiveness of standard fasting guidelines as assessed by gastric ultrasound examination: A clinical audit Indian J Anaesth., 62 (2018), pp. 747-752

12 R. Kruisselbrink, C. Arzola, R. Endersby, et al. Intra- and Interrater Reliability of Ultrasound Assessment of Gastric Volume Anesthesiology., 121 (2014), pp. 46-51

13 L. Bouvet, D. Chassard Ultrasound assessment of gastric contents in emergency patients examined in the full supine position: an appropriate composite ultrasound grading scale can finally be proposed J Clin Monit Comput., 34 (2020), pp. 865-868

6107f9cca95395419764c8a3 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections