Bisinotto Flora Margarida Barra, Pansani Patrícia Luísa, Silveira Luciano Alves Matias da, Naves Aline de Araújo, Peixoto Ana Cristina Abdu, Lima Hellen Moreira de, Martins Laura Bisinotto
MD, Anesthesiologist. PhD in Anesthesiology. Adjunct Professor, Department of Surgery, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.
MD, Anesthesiologist. Medical Residency in Anesthesiology at the Teaching and Training Center (CET)/Sociedade Brasileira de Anestesiologia (SBA), Hospital de Clínicas da UFTM, Uberaba, MG, Brazil.
Rev Assoc Med Bras (1992). 2017 Feb;63(2):134-141. doi: 10.1590/1806-9282.63.02.134.
: Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content.
: A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal. A qualitative and quantitative assessment of the gastric content in the antrum was performed by a blinded sonographer. The antrum was considered either as empty, or containing clear or thick fluid, or solids. Total gastric volume was predicted based on a cross-sectional area of the antrum. A p-value less than 0.05 was considered statistically significant.
: For each type of gastric content, the sonographic characteristics of the antrum and its content were described and illustrated. Sonographic qualitative assessment allowed to distinguish between an empty stomach and one with different kinds of meal. The predicted gastric volume was significantly larger after the consumption of any food source compared to fasting.
: Bedside sonography can determine the nature of gastric content. It is also possible to estimate the difference between an empty gastric antrum and one that has some food in it. Such information may be useful to estimate the risk of aspiration, particularly in situations when prandial status is unknown or uncertain.
胃内容物的肺误吸是麻醉中最令人担忧的并发症之一。其预防依赖于术前禁食以及识别高危患者。目前缺乏一种可靠的评估胃容量的诊断工具。本研究以志愿者为对象，旨在评估超声检查识别胃内容物性质和数量的可行性。
对67名健康志愿者应用标准化的胃部扫描方案，在四种不同情况下评估胃窦：禁食、摄入清水、牛奶和固体食物后。由一名不知情的超声检查医师对胃窦内的胃内容物进行定性和定量评估。胃窦被视为要么为空，要么含有清澈或浓稠液体，要么含有固体。基于胃窦的横截面积预测胃总体积。p值小于0.05被认为具有统计学意义。
针对每种类型的胃内容物，描述并展示了胃窦及其内容物的超声特征。超声定性评估能够区分空腹的胃和含有不同种类食物的胃。与禁食相比，食用任何食物来源后预测的胃容量均显著更大。
床旁超声检查能够确定胃内容物的性质。也能够估计空胃窦与含有一些食物的胃窦之间的差异。此类信息可能有助于评估误吸风险，尤其是在进餐状态未知或不确定的情况下。
