is a staff CRNA at Associated Anesthesiologists, P.C., in Lincoln, Nebraska.
is an assistant professor and program director of diagnostic medical sonography at Bryan College of Health Sciences, Department of Health Professions, Lincoln, Nebraska.
AANA J. 2021 Feb;89(1):9-16.
Perioperative pulmonary aspiration (PPA) is a major cause of morbidity and mortality. During anesthesia, airway reflexes become depressed, placing patients at risk of PPA. Gastric ultrasonography (GUS) can be used to qualitatively differentiate between solids, liquids, and empty gastric contents. The purpose of this study was to determine the sensitivity and specificity of GUS in identifying gastric contents after participants were randomly assigned to consume 1 donut, drink 360 mL of water, or remain fasted (n=60 each group). Ultrasonography was performed by a blinded scanner, and qualitative findings were recorded by 2 sonography examiners and the primary scanner. Findings from the water group included a sensitivity of 95% to 100% and specificity of 87.5% to 90% for identification of liquids. Interrater reliability results yielded an intraclass correlation coefficient (ICC)=.781 for the solid group; ICC=.950 for the fluid group; and ICC=.761 for the fasted group. Statistically significant differences were found for the effect that body mass index classifications had on sensitivity and specificity of GUS for predicting gastric content. Results of this study demonstrated that GUS is highly sensitive, specific, and reliable with low false-positive and false-negative rates in the identification of fluid gastric content.
围手术期肺吸入（PPA）是发病率和死亡率的主要原因。在麻醉期间，气道反射会受到抑制，使患者有发生 PPA 的风险。胃超声检查（GUS）可用于定性区分固体、液体和空胃内容物。本研究的目的是确定 GUS 在随机分配给参与者后识别胃内容物的敏感性和特异性，参与者分别进食 1 个甜甜圈、饮用 360 毫升水或禁食（每组 60 人）。由一名盲法扫描仪进行超声检查，两名超声检查者和主要扫描仪记录定性结果。水组的发现包括液体识别的敏感性为 95%至 100%，特异性为 87.5%至 90%。固体组的组内相关系数（ICC）为.781；液体组 ICC=.950；禁食组 ICC=.761。结果发现，GUS 预测胃内容物的 BMI 分类对其敏感性和特异性有显著影响。本研究结果表明，GUS 在识别液体胃内容物方面具有高度的敏感性、特异性和可靠性，假阳性和假阴性率低。
