Ultrasonographic Assessment of Gastric Volume in Fasted Patients Undergoing Gastrointestinal Endoscopy Under Sedation.

IF 2.3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Therapeutics and Clinical Risk Management Pub Date : 2023-01-01 DOI:10.2147/TCRM.S424890

Heng Rong, Weixin Dai, Yinying Qin, Zhikeng Meng, Xia Zou, Binbin Wang, Qiufeng Wei, Yubo Xie

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Abstract

Purpose: In this prospective observational study, an ultrasonographic measurement of antral cross-sectional area (ACSA) was conducted to evaluate the gastric content and volume as well as to identify high-risk stomach in non-pregnant adult surgical patients adhering to preanesthetic fasting guidelines.

Patients and methods: Fasted patients undergoing gastrointestinal endoscopy under sedation were included. Ultrasonographic measurements of ACSA were conducted in both semi-recumbent and right lateral decubitus positions before endoscopic procedures. Gastroscopy was employed to guide the measurement of suctioned gastric volume (GV). Ultrasonography was performed to assess gastric contents and identify patients with high-risk stomach. The relationship between ACSA and suctioned GV was also evaluated.

Results: ACSA was evaluated in 736 out of 782 patients. A significant positive correlation was discovered between ACSA in the right lateral decubitus position and suctioned GV, which was more reliable than in the semi-recumbent position. To analyze high-risk stomach with a GV > 100 mL, the cutoff value of ACSA in the right lateral decubitus was found to be 7.5 cm², with the AUC, sensitivity and specificity of 0.80 (95% CI, 0.76-0.82; P<0.001), 82.4% and 67.3%, respectively. A novel mathematical model based on ACSA to estimate GV in non-pregnant fasted adults was presented.

Conclusion: Ultrasonographic measurement of ACSA can assist anesthesiologists in estimating the risk of pulmonary aspiration of gastric contents during general anesthesia and sedation.

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镇静下禁食胃肠内镜检查患者胃容量的超声评估。

目的:在这项前瞻性观察研究中，通过超声测量胃窦横断面积(ACSA)来评估非妊娠成人手术患者遵守麻醉前禁食指南的胃内容物和胃容量，并识别高危胃。患者和方法:纳入镇静下禁食的胃肠内镜检查患者。超声测量ACSA在半卧位和右侧卧位进行内镜手术前。采用胃镜指导吸胃容积(GV)的测量。超声检查评估胃内容物，识别高危胃患者。并评价了ACSA与抽吸GV的关系。结果:782例患者中有736例进行了ACSA评估。右侧侧卧位的ACSA与抽吸的GV呈显著正相关，比半卧位更可靠。分析GV > 100 mL的高危胃，发现右侧卧位ACSA的临界值为7.5 cm2, AUC、敏感性和特异性为0.80 (95% CI, 0.76-0.82;结论:超声测量ACSA可帮助麻醉医师评估全麻及镇静时肺误吸胃内容物的风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

4.80

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.