Current Practice of Perioperative Gastric Regurgitation and Pulmonary Aspiration Management in China: A Cross-Sectional Survey.

Background and objective: Aspiration of gastric contents is the major cause of respiratory tract-related complications, which can lead to death. Despite its significance, nationwide research on the practice of managing gastric regurgitation and pulmonary aspiration remains inadequate. We aimed to conduct a national survey to gain an in-depth understanding of the management and clinical practices surrounding perioperative gastric regurgitation and pulmonary aspiration among anesthesiologists in China.

Methods: A 26-item questionnaire was sent to all registered anesthesiologist members via WeChat and the New Youth Anesthesia Forum website.

Results: A significant portion (70.77%) of respondents reported having encountered gastric regurgitation or pulmonary aspiration, with 50.15% experiencing cases where both regurgitation and aspiration occurred. While most patients had a favorable prognosis following aspiration, 20.63% and 20.72% of respondents indicated that their patients developed severe pneumonia or died as a result. Regurgitation and aspiration events mainly occurred during emergency surgery (86.39%), with abdominal operation (78.86%) being the most common. The induction of general anesthesia was identified as the most common phase for these events (75.33%). Rapid sequence induction (RSI) was employed by 61.98% of respondents. While 59.97% of respondents reported that their departments provided training on regurgitation and aspiration, only 20.34% had training specifically in gastric ultrasound technology. Additionally, 41.63% of the respondents' institutions were equipped with gastric ultrasound devices. A small fraction (14.93%) of respondents were proficient in gastric ultrasound examination techniques, while 20.99% were completely unfamiliar with the technology.

Conclusion: Our survey revealed that gastric regurgitation and pulmonary aspiration, as major threats to the safety of perioperative patients, still pose significant challenges in the practice of anesthesia in China. There are still many deficiencies in management. Strengthening training and improving resource allocation, especially in the adoption and widespread use of gastric ultrasound technology, are the directions that need to be improved in the future.