Department of Anaesthesia, Toronto Western Hospital, University Health Network, 399 Bathurst Street, McL 2-405, Toronto, ON, Canada M5S 2S8.
Department of Anaesthesia, Mount Sinai Hospital, Toronto, ON, Canada.
Br J Anaesth. 2017 Jan;118(1):77-82. doi: 10.1093/bja/aew400.
Point-of-care gastric ultrasound is an emerging tool to assess gastric content and volume at the bedside. The examination includes both a qualitative and a quantitative component. The aim of this study was to evaluate the performance of an existing model for predicting gastric volume in severely obese subjects (BMI >35 kg m).
This observer-blinded experimental study compared the gastric volume predicted based on a sonographically measured cross-sectional area of the gastric antrum with the gastric volume measured by suctioning under gastroscopic guidance in a cohort of severely obese subjects. Volumes between 0 and 400 ml, in 100 ml increments, were studied. Allocation was randomized, and all study observations were blinded to group allocation. The correlation and the level of agreement between predicted and observed volumes were studied.
Data from 38 subjects suggested that the gastric volume predicted by sonographic assessment correlated strongly with that measured by gastric suctioning (concordance correlation coefficient of 0.82 and Pearson's correlation coefficient of 0.86). In addition, Bland-Altman analysis suggested a high level of agreement between the calculated and suctioned volumes, with a mean difference of 35 ml, and 95% limits of agreement similar (within 30%) to those observed in the non-obese population.
Our results suggest that the existing mathematical model to determine gastric fluid volume based on sonographic assessment performs well in severely obese individuals.
床边即时胃超声是一种评估胃内容物和容量的新兴工具。该检查包括定性和定量两部分。本研究的目的是评估现有的用于预测肥胖患者（BMI>35kg/m²）胃容量模型的性能。
本观察者盲法实验研究比较了基于胃窦超声测量的横截面积预测的胃容量与胃镜引导下抽吸测量的胃容量，研究了 0 至 400ml 之间、以 100ml 为增量的胃容量。分配是随机的，所有研究观察结果均对分组分配进行了盲法。研究了预测和观察到的体积之间的相关性和一致性水平。
38 名受试者的数据表明，超声评估预测的胃容量与抽吸测量的胃容量密切相关（一致性相关系数为 0.82，皮尔逊相关系数为 0.86）。此外，Bland-Altman 分析表明，计算体积和抽吸体积之间具有高度一致性，平均差异为 35ml，95%一致性界限（在 30%范围内）与非肥胖人群观察到的相似。
我们的结果表明，现有的基于超声评估确定胃液量的数学模型在肥胖患者中表现良好。
