Amaral Caio Klippel, Benevides Márcio Luiz, Benevides Marília Marquioreto, Sampaio Diogo Leite, Fontes Cor Jesus Fernandes
Hospital Santa Helena, Cuiabá, MT, Brasil.
Universidade de Cuiabá, Faculdade de Medicina Cuiabá, MT, Brasil.
Braz J Anesthesiol. 2019 May-Jun;69(3):266-271. doi: 10.1016/j.bjan.2019.03.001. Epub 2019 Apr 19.
Pregnant women are considered patients at risk for pulmonary aspiration of gastric contents. The study aim was to evaluate the gastric antral cross-sectional area using ultrasound.
In this prospective study, 85 scheduled term pregnant women underwent gastric ultrasound. The outcomes were the measurement of the gastric antral cross-sectional area (main outcome), the estimated gastric volume, the incidence of pregnant women at risk for pulmonary aspiration, and the association between gastric antral cross-sectional area and clinical-demographic characteristics. Gastric antral cross-sectional area and gastric volume were compared according to body mass index <30 or ≥30.
The median (IIQ) for gastric antral cross-sectional area was 4 cm (2.8–6.3), for the estimated gastric volume it was 49.8 mL (33.7–87.2), and for the gastric volume estimated in mL.kg it was 0.62 mL.kg (0.39–0.95). The 95 percentile [95% confidence interval (CI)] of the gastric antral cross-sectional area and the estimated gastric volume were ≤10.3 cm (95% CI: 7.6–15.6) and 1.42 mL.kg (95% CI: 1.20–2.64), respectively. The incidence of pregnant women at risk for pulmonary aspiration was 3.5% (CI: 3.5 (1.2–9.8)). There was a positive correlation between gastric antral cross-sectional area and weight, < 0.001 and body mass index <0.001. Patients with a body mass index ≥30 had a gastric antral cross-sectional area and an estimated gastric volume greater than those with a body mass index <30, respectively, < 0.01 and < 0.02.
Measuring the gastric antral cross-sectional area of pregnant women is feasible and easy. There was positive correlation between gastric antral cross-sectional area, body weight and body mass index. The estimation of gastric volume by measuring the gastric antral cross-sectional area can identify patients at risk for pulmonary aspiration. Obese patients had a gastric antral cross-sectional area and an estimated gastric volume greater than non-obese patients.
孕妇被视为有胃内容物肺误吸风险的患者。本研究旨在通过超声评估胃窦横截面积。
在这项前瞻性研究中，85名足月待产孕妇接受了胃部超声检查。观察指标包括胃窦横截面积测量（主要观察指标）、估计胃容积、有肺误吸风险的孕妇发生率，以及胃窦横截面积与临床人口学特征之间的关联。根据体重指数<30或≥30比较胃窦横截面积和胃容积。
胃窦横截面积的中位数（四分位间距）为4 cm（2.8 - 6.3），估计胃容积为49.8 mL（33.7 - 87.2），以mL/kg为单位估计的胃容积为0.62 mL/kg（0.39 - 0.95）。胃窦横截面积和估计胃容积的第95百分位数[95%置信区间（CI）]分别≤10.3 cm（95% CI：7.6 - 15.6）和1.42 mL/kg（95% CI：1.20 - 2.64）。有肺误吸风险的孕妇发生率为3.5%（CI：3.5（1.2 - 9.8））。胃窦横截面积与体重（P<0.001）和体重指数（P<0.001）呈正相关。体重指数≥30的患者胃窦横截面积和估计胃容积分别大于体重指数<30的患者（P<0.01和P<0.02）。
测量孕妇胃窦横截面积可行且简便。胃窦横截面积与体重、体重指数呈正相关。通过测量胃窦横截面积估计胃容积可识别有肺误吸风险的患者。肥胖患者的胃窦横截面积和估计胃容积大于非肥胖患者。
