Relationship between the regurgitated and the aspirated volume of water. A manikin study

Bouvet, Lionel; Cercueil, Eloïse; Barnoud, Sophie; Lilot, Marc; Desgranges, François-Pierrick; Chassard, D.

doi:10.5114/ait.2019.85953

Cited by 6 publications

(8 citation statements)

References 13 publications

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“…These results corroborate those of a previous study performed on a life-like manikin that reported a high correlation between injected and collected volume of water, with a larger collected volume when the head of the manikin was in the sniffing position vs the extension position [10]. However, the proportion of water passing into the trachea was somewhat increased in the cadaver model compared to the manikin model previously used, since more than 85% of injected water entered the trachea in the human cadavers, while the rate of collected water ranged from 0 to 90% of injected water in the manikin [10]. This discrepancy between the two models may be related to some differences in the elasticity of the tissues, even if anatomical features of life-like manikins are similar to those of humans.…”

Section: Discussionsupporting

confidence: 91%

“…The second step is mostly dependent on anatomical and on head and body position factors [ 7 – 9 ]. In a recent study using a life-like manikin, we found that the minimal value of the volume of liquid regurgitated that may lead to pulmonary aspiration of fluid volume ≥ 0.8 mL kg -1 was around 1 mL kg -1 when the head was in the sniffing position, and around 1.8 mL kg -1 when the head was in the extension position [ 10 ]. Nevertheless, the use of a manikin as a model of pulmonary aspiration raised some issues regarding the generalizability of the results due to important differences compared to humans with respect to the compliance of the tissues.…”

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confidence: 99%

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Effect of patient head position on the aspirated volume of regurgitated clear fluid. A fresh human cadaver study

Bouvet¹,

Stevic²,

Cercueil³

et al. 2020

ait

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Pulmonary aspiration of gastric contents is mainly due to regurgitation or vomiting that may occur during laryngoscopy or tracheal extubation, or during ventilation via a laryngeal mask airway, or in sedated patients [1,2]. Increased gastric content volume is one of the conditions required for aspiration to occur; it is also a determining factor of the severity of pulmonary injury related to aspiration [3]. Thus, results of previous animal studies have suggested that aspiration of acidic fluid volume ≥ 0.8 mL kg -1 may result in severe lung injury in humans [3].The relationship between gastric fluid volume and pulmonary aspiration may be divided into two steps: a first step corresponding to the occurrence of regurgitation or of vomiting, and a second step corresponding to the relationship between regurgitated (or vomited) volume and aspirated volume of fluid. The first step is multifactorial as it depends on the decrease in the lower oesophageal sphincter pressure due to general anaesthesia and/or on the increase in intragastric pressure due to a full stomach or to

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Section: Discussionsupporting

confidence: 91%

mentioning

confidence: 99%

Effect of patient head position on the aspirated volume of regurgitated clear fluid. A fresh human cadaver study

Bouvet¹,

Stevic²,

Cercueil³

et al. 2020

ait

Self Cite

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“…Whether any motivator promotes PA under the premise of regurgitation remains unclear. A study performed on a life-like manikin suggested that a large regurgitant gastric fluid volume and sniffing position may contribute to PA occurrence (16). However, conducting relevant experimental studies on humans is impossible.…”

Section: Discussionmentioning

confidence: 99%

Perioperative pulmonary aspiration and regurgitation without aspiration in adults: a retrospective observational study of 166,491 anesthesia records

Sun¹,

Wei²,

Hu³

et al. 2021

Ann Palliat Med

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Background: Pulmonary aspiration (PA) of gastric contents is a rare but serious perioperative complication. Recent studies focused on pediatric patients, but over a decade has passed since the latest incidence and outcome in adult population have been reported. Patients who experienced regurgitation without aspiration were rarely mentioned. Besides, our department proposed a modified rapid sequence induction (RSI) protocol in 2018 and its preventive effect remained to be examined.Methods: A total of 166,491 anesthesia records from March 2015-October 2020 were reviewed. Outcomes from regurgitation events were classified as PA or regurgitation without aspiration following strict criteria.Available information including demographics, anesthetic managements, surgical procedures, and other medical records were reviewed for analysis.

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“…On the other hand, food and fluid restriction causes the stomach to empty, reducing the risk of pulmonary aspiration of gastric contents. It was proven that ≥ 1 mL kg −1 of fluid in the stomach may cause a clinically significant risk of aspiration (Bouvet et al 2019 ). Thus, intravenous liquids are administered.…”

Section: Introductionmentioning

confidence: 99%

The influence of fasting and carbohydrate-enriched drink administration on body water amount and distribution: a volunteer randomized study

et al. 2021

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Background Fasting prior to anesthesia is considered aspiration prophylaxis. However, prolonged food and drink restrictions may increase the risk of other complications. The aim of this study was to assess whether a carbohydrate-enriched drink (Nutricia™ preOp®), recommended by the enhanced recovery after surgery (ERAS) protocol, can improve body hydration in fasting healthy individuals. Methods Measurements were done with the bioelectric impedance analysis with a Fresenius body composition monitor. Body composition, total body water, water distribution, and hemodynamic parameters were measured at the beginning of the study and after 10 h and 12 h of fasting. Patients fasted for 10 h and then were divided into two groups: the control (n = 40) and the pre-op group (n = 41). The pre-op group received 400 mL of Nutricia™ preOp®, as suggested in the ERAS guidance. The two-tailed Student’s t test was used to compare two groups with normally distributed data and homogenous variances; if variances were heterogeneous, Welch’s test was used. The Mann-Whitney U test was used to compare two groups with non-normal data distribution. p < 0.05 was considered statistically significant. Results We found no significant differences between the control and pre-op groups regarding body water distribution and body composition. We did not observe significant losses in the total body water after fasting. Also, blood pressure was not affected by fasting. Conclusion We have proven that pre-op did not impact either body composition or body water. Trial registration ClinicalTrials.gov, NCT04665349. Registered on 11 December 2020—retrospectively registered.

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Relationship between the regurgitated and the aspirated volume of water. A manikin study

Cited by 6 publications

References 13 publications

Effect of patient head position on the aspirated volume of regurgitated clear fluid. A fresh human cadaver study

Effect of patient head position on the aspirated volume of regurgitated clear fluid. A fresh human cadaver study

Perioperative pulmonary aspiration and regurgitation without aspiration in adults: a retrospective observational study of 166,491 anesthesia records

The influence of fasting and carbohydrate-enriched drink administration on body water amount and distribution: a volunteer randomized study

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