Gastric Sonography in the Fasted Surgical Patient

Perlas, Anahi; Davis, Liisa; Khan, Masood A.; Mitsakakis, Nicholas; Chan, Vincent

doi:10.1213/ane.0b013e31821b98c0

Cited by 261 publications

(248 citation statements)

References 28 publications

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“…Nevertheless, if the gastric sonogram should show clear fluid content, a quantitative volume assessment can help differentiate a low-volume status (similar to baseline physiologic gastric content) from a high-volume status (higher than baseline gastric volume). [11][12][13] We concentrated instead on using a focused qualitative exam as an approach to a screening test. Second, although we assessed quite distinct categories of gastric content and performed the ultrasound assessments at fairly constant time points, scanning conditions for the individual participants could have varied during the course of the session.…”

Section: Discussionmentioning

confidence: 99%

“…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%

“…[10][11][12][13][14] In these studies, either a certified sonographer or a single anesthesiologist with no specified previous training performed all the examinations. [11][12][13][15][16][17] The process of knowledge translation demands further research to confirm generalizability of these findings. The amount of training required to achieve competence in the performance of gastric ultrasonography as a bedside clinical tool remains unknown.…”

Section: Résumémentioning

confidence: 99%

“…The reading material included research studies [11][12][13][14] and one educational article with a description of the technique. 19 Subsequently, the teaching proceeded with an interactive three-hour session consisting of a hands-on workshop and a live demonstration performed by the expert sonographer.…”

Section: Teaching Interventionmentioning

confidence: 99%

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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

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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%

Section: Discussionmentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

Section: Teaching Interventionmentioning

confidence: 99%

See 2 more Smart Citations

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

Self Cite

113

View full text Add to dashboard Cite

show abstract

“…Empty stomachs in healthy individuals often have a small baseline volume of gastric secretions (up to 1.6 mLÁkg -1 ). 17 Subjects were asked to ingest 200 mL of clear fluid and milk, as this volume was chosen to be higher than the upper limit of a normal baseline fasting volume. A twodimensional ultrasound assessment was performed using either a portable General Electric Logiq e unit (GE Healthcare, Mississauga, ON, Canada) or a Philips CX50 unit (Philips Healthcare, Andover, MA, USA) with a low-frequency (2-5 MHz) curved array transducer or a high-frequency (8-13 MHz) linear array transducer, as appropriate.…”

Section: Methodsmentioning

confidence: 99%