was a student at Duke University School of Nursing, Durham, North Carolina, at the time of writing this article and is now a CRNA at Northwestern Memorial Hospital in Chicago.
is a consulting associate for the Duke University Nurse Anesthesia Program. Andi has practiced as a CRNA in academic institutions, community hospitals, and outpatient and office-based practices since 2012.
AANA J. 2020 Apr;88(2):107-113.
The presence of gastric content before induction of general anesthesia is the primary modifiable risk factor in the prevention of pulmonary aspiration. The purpose of this project was to determine if ultrasonography could be routinely used to measure gastric content and assign aspiration risk in patients undergoing general anesthesia. Preoperative gastric ultrasonography was performed in a convenience sample of 100 patients. A group of Certified Registered Nurse Anesthetists, anesthesia residents, and anesthesiologists were asked their plan for airway management before and after receiving the results of the patients' gastric ultrasonogram, to determine if the scan would alter the plan. In 14% of patients scanned, solid gastric content was observed, 7% had clear liquids present, and 79% had an empty stomach. Of the patients with clear liquids present, 3 had substantial (> 100 mL) gastric content despite following fasting guidelines. Overall, there was a 9% change in airway management from standard induction: 6% changed to modified rapid sequence intubation (no ventilation, no cricoid pressure), and 3% changed to rapid sequence intubation with cricoid pressure. The number of changes to the airway management plan and identification of several patients with substantial gastric content demonstrate the value of preoperative gastric ultrasonography in airway management decision making.
在全身麻醉诱导前存在胃内容物是预防误吸的主要可改变的危险因素。本项目旨在确定超声检查是否可常规用于测量行全身麻醉患者的胃内容物并评估误吸风险。在 100 例方便取样的患者中进行了术前胃超声检查。一组注册护士麻醉师、麻醉住院医师和麻醉师在收到患者胃超声检查结果前后被要求告知其气道管理计划，以确定扫描是否会改变计划。在接受检查的患者中，有 14%观察到有固体胃内容物，7%有清亮液体，79%为空胃。在有清亮液体的患者中，尽管遵循了禁食指南，但仍有 3 例存在大量 (>100 毫升) 胃内容物。总体而言，气道管理从标准诱导发生了 9%的变化：6%改为改良快速序贯诱导（无通气，无环甲膜压迫），3%改为环甲膜压迫下快速序贯诱导。气道管理计划的变化次数以及发现几例存在大量胃内容物的患者表明，术前胃超声检查对气道管理决策具有重要价值。
