Facultat de Ciències de La Salut, Universitat de Barcelona, Barcelona, Spain.
Anesthesiology Department, Hospital Clinic Barcelona, Villaroel 170, Esc 4-3, Barcelona, Spain.
J Clin Monit Comput. 2021 May;35(3):483-489. doi: 10.1007/s10877-020-00489-9. Epub 2020 Mar 2.
Perioperative pulmonary aspiration of gastric content is a serious complication. Fasting guidelines try to ensure an empty stomach before intervention. Certain medications or pathologies may cause delayed gastric emptying. Bedside ultrasonography is a useful tool when gastric content status is unclear or in emergency situations where fasting is not feasible. The aim of this prospective case-control observational study was to assess differences in gastric fluid volume between fasted patients with or without predisposing factors for delayed gastric emptying. Patients were preoperatively scanned. Antral cross-sectional area was measured by two tracing methods and total gastric clear fluid volumes were calculated. Data was recorded from September 2018 to March 2019 in a university hospital setting in Barcelona, Spain. Fifty-three patients were enrolled, 23 with delayed gastric emptying predisposing factors (DGEF) and 30 without non-DGEF. Ultrasound-estimated gastric clear fluid volume was 35.21 ± 32.69 mL in the DGEF versus 53.50 ± 30.72 mL in the non-DGEF group (p = 0.08). Average volume per unit of weight was 0.61 ± 0.46 mL/kg. Only 1 patient in the DGEF group had a volume that posed a higher risk of aspiration (1.57 mL/kg). Perfect correlation (R = 0.91; p < 0.01) and concordance (0.91; 95% CI 0.83; 0.95) was found between tracing methods. Minimal gastric content was observed in scheduled surgery in spite of predisposing factors for delayed gastric emptying. Ultrasound clear gastric volume estimation was useful to assess preoperative bedside gastric content.
围手术期胃内容物吸入是一种严重的并发症。禁食指南试图确保在干预前排空胃部。某些药物或病理状况可能导致胃排空延迟。当胃内容物状态不清楚或在禁食不可行的紧急情况下，床边超声检查是一种有用的工具。本前瞻性病例对照观察研究的目的是评估禁食和无胃排空延迟危险因素的患者之间胃液体量的差异。患者术前进行扫描。通过两种追踪方法测量胃窦横截面积，并计算总胃清亮液体积。数据记录于 2018 年 9 月至 2019 年 3 月在西班牙巴塞罗那的一所大学医院进行。共纳入 53 例患者，其中 23 例有胃排空延迟危险因素（DGEF），30 例无非 DGEF。DGEF 组超声估计的胃清亮液体积为 35.21±32.69 mL，非 DGEF 组为 53.50±30.72 mL（p=0.08）。单位体重的平均体积为 0.61±0.46 mL/kg。DGEF 组中只有 1 例患者的体积存在更高的吸入风险（1.57 mL/kg）。两种追踪方法之间存在完美相关性（R=0.91；p<0.01）和一致性（0.91；95%可信区间 0.83；0.95）。尽管存在胃排空延迟的危险因素，但在择期手术中观察到最小的胃内容物。超声清亮胃体积估计有助于评估术前床边胃内容物。
