Department of Anaesthesiology, AZ Monica, Campus Deurne, Deurne, Belgium.
Department of Anaesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, ON, Canada Department of Anaesthesia, University of Toronto, 399 Bathurst St., Toronto, ON, Canada M5 T 2S8
Br J Anaesth. 2014 Jul;113(1):12-22. doi: 10.1093/bja/aeu151. Epub 2014 Jun 3.
Pulmonary aspiration of gastric content is a serious anaesthetic complication that can lead to significant morbidity and mortality. Aspiration risk assessment is usually based on fasting times. However, fasting guidelines do not apply to urgent or emergent situations and to patients with certain co-morbidities. Gastric content and volume assessment is a new point-of-care ultrasound application that can help determine aspiration risk. This systematic review summarizes the current literature on bedside ultrasound assessment of gastric content and volume relevant to anaesthesia practice. Seventeen articles were identified using predetermined criteria. Studies were classified into those describing the sonographic characteristics of different types of gastric content (empty, clear fluid, solid), and those describing methods for quantitative assessment of gastric volume. A possible algorithm for the clinical application of this new tool is proposed, and areas that require further research are highlighted.
胃内容物吸入是一种严重的麻醉并发症,可导致严重的发病率和死亡率。吸入风险评估通常基于禁食时间。然而,禁食指南不适用于紧急或紧急情况以及某些合并症患者。胃内容物和量的评估是一种新的即时超声应用,可以帮助确定吸入风险。本系统评价总结了当前关于床边超声评估与麻醉实践相关的胃内容物和量的文献。使用预定标准确定了 17 篇文章。研究分为描述不同类型胃内容物(空、清亮液体、固体)的超声特征的研究,以及描述定量评估胃容量方法的研究。提出了该新工具临床应用的一种可能算法,并强调了需要进一步研究的领域。