Schmitz Achim, Thomas Schraner, Melanie Fruehauf, Rabia Liamlahi, Klaghofer Richard, Weiss Markus, Kellenberger Christian
Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland.
Paediatr Anaesth. 2012 Feb;22(2):144-9. doi: 10.1111/j.1460-9592.2011.03718.x. Epub 2011 Oct 14.
Cross-sectional gastric antral area (GAA) measurements by ultrasonography (US) have been proposed for preoperative assessment of gastric volume in adults but not been validated in children. This study investigates whether in children gastric volumes can be predicted by US performed in different patient positions.
Gastric fluid and air volumes were examined by magnetic resonance imaging before or up to 120 min after ingestion of 7 ml·kg(-1) diluted raspberry syrup in healthy volunteers who had fasted overnight. GAA was measured with US three times each in supine (SUP), elevated 45° degree supine (E45) and right decubital (RDC) position using imaging planes defined by vascular landmarks. Correlation coefficients (Pearson) between GAA and gastric volumes were calculated and Bland-Altman analysis performed.
Sixteen children aged from 6.4 to 12.8 (9.2) years were included in 23 examinations: 6 after overnight fasting, 3 directly after, and 14 with a delay of 74 ± 35 min after fluid intake. GAA was 221 ± 116, 218 ± 112, and 347 ± 188 mm(2) for SUP, E45, and RDC position, respectively. The best correlation between body weight corrected total gastric/gastric fluid volume (TGV(w)/GFV(w)) with GAA was found for RDC position (R = 0.79; P < 0.01/R = 0.78; P < 0.01). Bias and precision of calculated and measured GFV(w) was 0 ± 2.8 ml·kg(-1).
Correlations between GAA and TGV(w) or GFV(w) in children are best in the RDC position, but not sufficient to predict GFV(w) with a given GAA. Interpretation of isolated GAA values may be misleading.
超声检查测量胃窦横截面积（GAA）已被用于成人胃容量的术前评估，但尚未在儿童中得到验证。本研究旨在探讨在儿童中，不同体位下超声检查能否预测胃容量。
在隔夜禁食的健康志愿者摄入7 ml·kg⁻¹稀释树莓糖浆之前或之后120分钟内，通过磁共振成像检查胃内液体和气体容量。使用由血管标志定义的成像平面，在仰卧位（SUP）、45°仰卧位（E45）和右侧卧位（RDC）分别对GAA进行三次测量。计算GAA与胃容量之间的相关系数（Pearson），并进行Bland-Altman分析。
23次检查纳入了16名年龄在6.4至12.8（9.2）岁的儿童：6例隔夜禁食后检查，3例进食后立即检查，14例进食后74±35分钟检查。SUP、E45和RDC体位的GAA分别为221±116、218±112和347±188 mm²。RDC体位下，体重校正后的总胃/胃液容量（TGV(w)/GFV(w)）与GAA的相关性最佳（R = 0.79；P < 0.01/R = 0.78；P < 0.01）。计算的和测量的GFV(w)的偏差和精密度为0±2.8 ml·kg⁻¹。
儿童中GAA与TGV(w)或GFV(w)的相关性在RDC体位最佳，但不足以根据给定的GAA预测GFV(w)。单独解释GAA值可能会产生误导。
