Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
BMC Anesthesiol. 2022 Jan 3;22(1):5. doi: 10.1186/s12871-021-01550-z.
Pulmonary aspiration is a major complication in anesthesia, and various studies have shown that gastric sonography can reliably provide valuable information relative to both the qualitative and quantitative aspects of gastric content. This study aimed to determine the accuracy of ultrasound assessment of gastric content compared between two novice anesthesiologist gastric sonographers.
This prospective cohort study of two anesthesiologists learning to perform qualitative and quantitative ultrasound assessment of gastric content on healthy volunteers was conducted at Siriraj Hospital (Bangkok, Thailand). This trial was registered with ClinicalTrials.gov (reg. no. NCT04760106).
Of the 50 enrolled participants, three were excluded due to study protocol violation. Each anesthesiologist performed a qualitative assessment on 47 participants for an overall total of 94 scans. There were 15 males and 32 females (age 42 ± 11.7 years, weight 61.2 ± 13.1 kg, height 160.7 ± 7.3 cm, and BMI 23.6 ± 4.3 kg/m). The overall success rate for all gastric content categories was approximately 96%. From antral cross-sectional area measurement, as the ingested volume increased, there was a tendency toward increased deviation from the actual ingested volume. Interrater agreement between anesthesiologists was analyzed using intraclass correlation coefficients (ICCs). A larger fluid volume was found to be associated with a lower level of agreement between the two anesthesiologists. The ICCs were 0.706 (95% CI: -0.125 to 0.931), 0.669 (95% CI: -0.254 to 0.920), 0.362 (95% CI: -0.498 to 0.807) for the 100 ml, 200 ml, and 300 ml fluid volumes, respectively. The mean duration to perform an ultrasound examination for each gastric content category and for the entire examination did not differ significantly between anesthesiologists (p > 0.05).
Our results indicate that qualitative ultrasound assessment of gastric content is highly accurate and can be easily learned. In contrast, quantification of gastric volume by novice gastric sonographers is more complex and requires more training.
ClinicalTrials.gov no. NCT04760106 Date registered on Feb 11, 2021. Prospectively registered.
在麻醉中，肺吸入是一个主要的并发症，多项研究表明，胃超声检查可以可靠地提供有关胃内容物的定性和定量方面的有价值的信息。本研究旨在确定超声评估胃内容物的准确性，并比较两名新手麻醉科胃超声检查者之间的结果。
这项在泰国曼谷 Siriraj 医院进行的前瞻性队列研究纳入了学习对健康志愿者进行胃内容物定性和定量超声评估的两名麻醉科医生。该试验在 ClinicalTrials.gov 注册（注册号：NCT04760106）。
在 50 名入组的参与者中，有 3 名因违反研究方案而被排除。每位麻醉医生对 47 名参与者进行了定性评估，总共进行了 94 次扫描。参与者中有 15 名男性和 32 名女性（年龄 42 ± 11.7 岁，体重 61.2 ± 13.1kg，身高 160.7 ± 7.3cm，BMI 23.6 ± 4.3kg/m²）。所有胃内容物类别的总体成功率约为 96%。从胃窦横截面积测量来看，随着摄入的量增加，与实际摄入量的偏差有增加的趋势。使用组内相关系数（ICC）分析两位麻醉医生之间的评分者间一致性。发现更大的液体量与两位麻醉医生之间的一致性水平较低相关。对于 100ml、200ml 和 300ml 液体量，ICC 分别为 0.706（95%CI：-0.125 至 0.931）、0.669（95%CI：-0.254 至 0.920）和 0.362（95%CI：-0.498 至 0.807）。对于每个胃内容物类别和整个检查，两位麻醉医生进行超声检查的平均时间无显著差异（p>0.05）。
我们的结果表明，胃内容物的定性超声评估非常准确，且易于学习。相比之下，新手胃超声检查者对胃容量的定量评估则更加复杂，需要更多的培训。
ClinicalTrials.gov 注册号 NCT04760106 于 2021 年 2 月 11 日注册。前瞻性注册。
