Khandekar Sayali S, Doctor Jeson R, Awaskar Shilpa K, Alex Nidhin K, Medha Lipika R, Ranganathan Priya
Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Indian J Anaesth. 2022 Apr;66(4):255-259. doi: 10.4103/ija.ija_783_21. Epub 2022 Apr 20.
Bedside ultrasound (US) is used to evaluate gastric residual volume (GRV) and assess aspiration risk. We examined the accuracy of US-guided measurement of GRV using Perlas's formula, by two trained anaesthesiologists, in patients who had consumed different types and volumes of fluids.
Patients with no risk factors for delayed gastric emptying were included. Each assessor independently determined the baseline US-guided GRV. The patients were randomly allocated to receive no drink or 100 or 200 mL of water or milk. US-guided GRV was re-assessed within 5 min after the intervention. Investigators were blinded to the measurements performed by each other and to the randomisation arm. The primary outcome was the agreement between actual volumes consumed and estimated change in GRV.
Agreement between actual volume consumed and estimated change in GRV was poor [Intra-class correlation coefficient (ICC) 0.46, 95% confidence interval (CI) 0.09 to 0.72; = 0.09 for assessor 1 and ICC 0.37; 95% CI 0.02 to 0.66; = 0.03 for assessor 2].
US-guided GRV measurements using Perlas's formula, performed by trained anaesthesiologists may not be a reliable measure of GRV.
床旁超声(US)用于评估胃残余量(GRV)并评估误吸风险。我们在摄入不同类型和体积液体的患者中,由两名经过培训的麻醉医生使用佩拉斯公式,检查了超声引导下测量GRV的准确性。
纳入无胃排空延迟风险因素的患者。每位评估者独立确定超声引导下的基线GRV。患者被随机分配接受不饮水或100或200毫升水或牛奶。干预后5分钟内重新评估超声引导下的GRV。研究人员对彼此进行的测量以及随机分组情况不知情。主要结局是实际摄入量与GRV估计变化之间的一致性。
实际摄入量与GRV估计变化之间的一致性较差[组内相关系数(ICC)为0.46,95%置信区间(CI)为0.09至0.72;评估者1的P = 0.09,ICC为0.37;95% CI为0.02至0.66;评估者2的P = 0.03]。
由经过培训的麻醉医生使用佩拉斯公式进行超声引导下的GRV测量,可能不是GRV的可靠测量方法。