Gastric Emptying: Comparison of Scintigraphic, Polyethylene Glycol Dilution, and Paracetamol Tracer Assessment Techniques

Näslund, Erik; Bogefors, Jesper; Grybäck, Per; Jacobsson, Hans; Hellström, Per M.

doi:10.1080/003655200750023930

Cited by 99 publications

(64 citation statements)

References 10 publications

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“…It could help to establish the risk of perioperative aspiration more precisely, both in a given individual and in different patient populations. 9,12,14,40 Practice guidelines are subject to revision as warranted by the evolution of medical knowledge, technology, and practice. 9,41 Factors such as current literature, expert and practitioner opinion, open forum commentary, and clinical feasibility data support these recommendations.…”

Section: Discussionmentioning

confidence: 99%

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Arzola

Carvalho

Cubillos

et al. 2013

Can J Anesth/J Can Anesth

113

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Purpose Focused assessment of the gastric antrum by ultrasound is a feasible tool to evaluate the quality of the stomach content. We aimed to determine the amount of training an anesthesiologist would need to achieve competence in the bedside ultrasound technique for qualitative assessment of gastric content. Methods Six anesthesiologists underwent a teaching intervention followed by a formative assessment; then learning curves were constructed. Participants received didactic teaching (reading material, picture library, and lecture) and an interactive hands-on workshop on live models directed by an expert sonographer. The participants were instructed on how to perform a systematic qualitative assessment to diagnose one of three distinct categories of gastric content (empty, clear fluid, solid) in healthy volunteers. Individual learning curves were constructed using the cumulative sum method, and competence was defined as a 90% success rate in a series of ultrasound examinations. A predictive model was further developed based on the entire cohort performance to determine the number of cases required to achieve a 95% success rate. Results Each anesthesiologist performed 30 ultrasound examinations (a total of 180 assessments), and three of the six participants achieved competence. The average number of cases required to achieve 90% and 95% success rates was estimated to be 24 and 33, respectively. Conclusion With appropriate training and supervision, it is estimated that anesthesiologists will achieve a 95% success rate in bedside qualitative ultrasound assessment after performing approximately 33 examinations. RésuméObjectif L'évaluation ciblée de l'antre pylorique par échographie est un outil utile pour estimer la qualité du contenu de l'estomac. Notre objectif était de déterminer la quantité de formation nécessaire à un anesthésiologiste afin d'acquérir des compétences en échographie au chevet pour l'évaluation qualitative du contenu gastrique. Méthode Six anesthésiologistes ont suivi une formation, puis une évaluation formative; des courbes d'apprentissage ont ensuite été élaborées. Les participants ont reçu un enseignement didactique (matériel de lecture, bibliothèque d'images, et cours) et suivi un atelier pratique interactif sur

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Section: Discussionmentioning

confidence: 99%

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Arzola

Carvalho

Cubillos

et al. 2013

Can J Anesth/J Can Anesth

113

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“…Numerous methods have been used to measure gastric emptying (29). In the present study, we assessed gastric emptying by serving a solution of 3-OMG with the meal.…”

Section: Discussionmentioning

confidence: 99%

Bedtime Administration of NN2211, a Long-Acting GLP-1 Derivative, Substantially Reduces Fasting and Postprandial Glycemia in Type 2 Diabetes

et al. 2002

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Glucagon-like peptide 1 (GLP-1) is a potent glucoselowering agent of potential interest for the treatment of type 2 diabetes. To evaluate actions of NN2211, a long-acting GLP-1 derivative, we examined 11 patients with type 2 diabetes, age 59 ؎ 7 years (mean ؎ SD), BMI 28.9 ؎ 3.0 kg/m 2 , HbA 1c 6.5 ؎ 0.6%, in a double-blind, placebo-controlled, crossover design. A single injection (10 g/kg) of NN2211 was administered at 2300 h, and profiles of circulating insulin, C-peptide, glucose, and glucagon were monitored during the next 16.5 h. A standardized mixed meal was served at 1130 h. Efficacy analyses were performed for the fasting (7-8 h) and mealtime (1130 -1530 h) periods. Insulin secretory rates (ISR) were estimated by C-peptide deconvolution analysis. Glucose pulse entrainment (6 mg ⅐ kg ؊1 ⅐ min P atients with type 2 diabetes experience relative insulin deficiency as well as delayed and blunted meal-related insulin response (1). Glucagon excess contributes to the elevated fasting and postprandial glycemia (2). Because of a marked and glucosedependent insulinotropic action and a restraining effect on glucagon release, glucagon like peptide-1 (GLP-1) is an obvious candidate for the treatment of type 2 diabetes (3). In addition, GLP-1 delays gastric emptying and reduces appetite in patients with type 2 diabetes also in nonemetic doses (4). Continuous intravenous infusion and repeated subcutaneous injections of GLP-1 (7-36 amide) effectively reduce fasting plasma glucose as well as meal-related glycemia (3,5). Even in patients with type 2 diabetes and secondary failure of sulfonylurea treatment, GLP-1 has been demonstrated to reduce glycemia effectively (6).Increased ␤-cell function has been reported after overnight GLP-1 infusion, as measured by homeostasis model assessment (HOMA) and by first-and second-phase insulin secretion (7). The secretagogue effect is achieved by a concomitant increase of basal (nonpulsatile) and highfrequency pulsatile insulin release in patients with type 2 diabetes (8). In a study of ultradian insulin pulsatility, GLP-1 was reported to restore glucose entrainment in individuals with impaired glucose tolerance (9), indicating preferential effects on the coordination of insulin release.GLP-1 is rapidly cleaved by dipeptidyl-peptidase IV after both intravenous and subcutaneous injections, and the development of long-acting derivatives is needed for clinical use. NN2211 is an acylated GLP-1 derivative with prolonged action due to a combination of albumin binding, metabolic stability, and slow release from the injection site. NN2211 has shown a favorable pharmacokinetic

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“…Each of these techniques has advantages and disadvantages compared each other, and there are few data which deal comparison of the ultrasound measurements with other methods for gastric emptying. Among the GET methods, paraacetamol absorption kinetics after the oral ingestion of the drug has been used as an index of gastric and not requiring special equipment [10,18,23]. So it is considered that it would be more useful and objective to evaluate this ultrasonographic measurements with the help of paraacetamol absorption method for gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Canine Gastric Motility with Ultrasonography.

Choi

Seo

Jung

et al. 2002

The Journal of Veterinary Medical Science

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ABSTRACT. For the evaluation of canine gastric motility with ultrasonography, contraction number of pyloric antrum and gastric emptying time (GET) by area and volume method developed by Bolondi et al.'s method were studied in 14 dogs. All experimental dogs were administered with saline and soup solution (10 ml/kg, B.W.). The mean values of contraction number of pyloric antrum in saline and soup group were 4.19 ± 1.30/min and 4.82 ± 0.65/min before feeding, and overall mean values were 4.66 ± 1.37/min and 5.13 ± 1.71/ min, respectively. The mean values of the GET by area and volume method were 36.73 ± 11.27, 40.00 ± 8.87 min in saline group and 61.35 ± 17.58, 59.11 ± 14.46 min in soup group. In the GET in saline and soup groups, there was no significant difference between the area and volume method (p>0.05). Therefore, Bolondi et al.'s method by ultrasound can be used to evaluate the antropyloric motility and gastric emptying time with area and volume methods. The area method is easier to determine the GET than the volume method, but the latter is more accurate.

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Gastric Emptying: Comparison of Scintigraphic, Polyethylene Glycol Dilution, and Paracetamol Tracer Assessment Techniques

Cited by 99 publications

References 10 publications

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Anesthesiologists’ learning curves for bedside qualitative ultrasound assessment of gastric content: a cohort study

Bedtime Administration of NN2211, a Long-Acting GLP-1 Derivative, Substantially Reduces Fasting and Postprandial Glycemia in Type 2 Diabetes

Evaluation of Canine Gastric Motility with Ultrasonography.

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