Through a glass darkly - ultrasound imaging in obstetric anaesthesia

The link between gastric volume and aspiration risk. In search of the Holy Grail?

“…Given the lack of a non‐invasive tool to assess gastric volume in humans, there was little progress in this area of study for several decades . The recent introduction of point‐of‐care gastric ultrasound has rekindled the interest and discussion adding new perspectives and fresh human data to our understanding . There has been a burst of new publications recently, including two in this issue of Anaesthesia .…”

Changes in qualitative and quantitative ultrasound assessment of the gastric antrum before and after elective caesarean section in term pregnant women: a prospective cohort study

“…In pregnant women, ultrasound measurement of the antral cross-sectional area has been used to study the gastric emptying of water [8,9], and to assess the effect of diet on gastric contents during labour [10]. Several recent studies have reported that gastric antral ultrasound might also be a point-of-care diagnostic tool for the assessment of the risk of pulmonary aspiration during general anaesthesia [11]. Arzola et al confirmed that anaesthetists were consistently able to assess gastric contents during the last trimester of pregnancy [12].…”

Socially accountable anaesthesia: matching human resources with community need for safe care

“…Given the lack of a non-invasive tool to assess gastric volume in humans, there was little progress in this area of study for several decades [12]. The recent introduction of point-ofcare gastric ultrasound has rekindled the interest and discussion adding new perspectives and fresh human data to our understanding [13,14]. There has been a burst of new publications recently, including two in this issue of Anaesthesia [15,16].…”

“…Third: who should perform and learn gastric ultrasound? It seems reasonable to propose that, given the great importance of aspiration prevention in the practice of anaesthesia, emergency and intensive care, gastric point-of-care ultrasound should be part of the armamentarium of any clinician involved in these areas of patient care, similar to lung or [13,32,33]. More studies are needed to determine the best methods to teach and learn this new skill, the most appropriate timing within the curriculum and the secondary impact on curriculum content overall.…”