Ultrasonograficzna ocena wypełnienia żołądka a ryzyko aspiracji treści pokarmowej w okresie okołooperacyjnym

Gola, Wojciech; Domagała, Michał; Cugowski, Adam

doi:10.5603/ait.a2018.0029

Cited by 11 publications

(7 citation statements)

References 21 publications

(26 reference statements)

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“…Ultrasound examination of the gastric antrum has been recently described and validated for the preoperative assessment of gastric contents and volume [5][6][7][8]. In particular, the ultrasound measurement of the antral cross-sectional area in the right lateral decubitus position allows the calculation of gastric fluid volume [7], but the critical value of the gastric fluid volume enabling discrimination between high and low risk of aspiration remains controversial [9].…”

Section: Original and Clinical Articlesmentioning

confidence: 99%

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

Bouvet

Cercueil

Barnoud

et al. 2019

ait

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Background:The relationship between gastric fluid volume, volume of fluid regurgitated, and aspirated fluid volume remains unclear. Using a life-like manikin suitable for a pulmonary aspiration model, we aimed to assess the relationship between regurgitated and aspirated clear fluid volumes, and to determine the minimal value of the volume of liquid regurgitated that may lead to pulmonary aspiration of fluid volume ≥ 0.8 mL kg -1 (around 60 mL) that is likely to cause lung injury.Methods: Several volumes of water ranging from 30 to 150 mL were injected in a randomized order, at a flow rate of 20 mL per second, into the esophagus of a manikin lying in the supine position on a non-tilted table, with the manikin head in the extension or in the sniffing position. Aspirated volumes were measured in the manikin bronchi, by an investigator blinded to the volume injected. Aspiration was defined as positive when the volume of collected water was ≥ 60 mL for at least one of the five injections of each volume of water.Results: The minimal volume of water injected into the esophagus for an aspirated volume ≥ 0.8 mL kg -1 was 85 mL in the sniffing position, and was 150 mL in the extension position. Conclusions: These results suggest that the critical cut-off value of gastric fluid volume to be considered for the risk of significant pulmonary aspiration would be ≥ 85 mL (≥ 1 mL kg -1 ), in the sniffing position. These results should however be confirmed in further studies using other models.

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Section: Original and Clinical Articlesmentioning

confidence: 99%

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

Bouvet

Cercueil

Barnoud

et al. 2019

ait

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“…The findings should be considered in the benefit to risk ratio relative to improvements in weight, glycemic control, and other cardiometabolic benefits of this class of medications when used in the treatment of obesity and T2DM. Our data illustrate the relevance of the guidance from the American Society of Anesthesiologists [3] on management of GLP-1 RA treatment prior to operative procedures during the preceding week(s) with longacting GLP-1 RAs or days with short-acting GLP-1 RAs and the option of point-of-care ultrasound to measure gastric residue [4] in such patients.…”

mentioning

confidence: 59%

Prevalence and variations in gastric emptying delay in response to GLP‐1 receptor agonist liraglutide

Camilleri,

Carlson,

Dilmaghani

2023

Obesity

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Public interest has exploded on the potential of glucagon-like peptide-1 (GLP-1) receptor agonists (RA) to delay gastric emptying (GE), cause chronic gastroparesis, and risk aspiration during surgical procedures. In a prospective, randomized, placebo-controlled trial from our group published in Obesity, we evaluated liraglutide, titrated to 3 mg during the first 5 weeks and dose maintained for the next 11 weeks, in adults with obesity but without type 2 diabetes (T2DM) or delayed GE at baseline [1]. GE of solids was measured as previously reported [1, 2]; the 95th percentile for normal GE half-emptying time (T 1/2 ) of 174 minutes [2] was used to define delayed GE. Liraglutide slowed GE T 1/2 at 5 and 16 weeks compared with placebo [1]. In that study, GE delay and variations in GLP1R (GLP-1 receptor gene) and TCF7L2 (which controls endogenous GLP-1 synthesis) were associated with liraglutide effects [1]. This letter describes a post hoc, follow-on analysis of the same GE data [1]: among 67 patients treated with liraglutide, we estimated the risk of delayed GE in the first 5 weeks and likelihood of improvement

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“…[ 20 , 22 ] Nowadays, the emptiness of the stomach can be easily assessed with gastric ultrasound at the bedside. [ 23 ] The assessment of pulmonary aspiration risk with gastric ultrasound involves several steps. [ 4 ] First, qualitative assessment of gastric contents (i.e., whether the stomach is empty or contains fluid or solid) is performed.…”

Section: Discussionmentioning

confidence: 99%

Differences in preoperative gastric ultrasound findings in elderly compared to the mid-aged surgical patients: A retrospective observational study

et al. 2023

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This study aimed to compare gastric ultrasound assessments between young and elderly patients, to determine whether the cross-section area (CSA) cutoff values for elderly and young patients should be different, and to suggest CSA cutoff values for elderly patients. This study evaluated the data of 120 patients who underwent elective surgery under general anesthesia between July 2019 and August 2020. Demographic and gastric ultrasound assessment data were retrieved. Patients were divided into the elderly group (n = 58, age: ≥65 years) and young group (n = 62, age: <65 years). The CSAs in the supine and right lateral decubitus positions (RLDP), semiquantitative 3-point Perlas grade (grades 0, 1, and 2), and gastric volume (GV) were determined. CSAs according to different Perlas grades were compared between the 2 groups. To compare normally and non-normally distributed continuous data, Student t test and the Mann–Whitney U test were used, respectively. Categorical data were compared using the chi-square test or Fisher exact test, as appropriate. The receiver operating characteristic (ROC) curves were built for the CSAs to predict pulmonary aspiration. The CSA cutoff values for predicting a high risk of pulmonary aspiration in both the groups were determined. Among patients with Perlas grade 0, the CSA supine ( P = .002) and CSA RLDP ( P = .002) were greater in the elderly group than in the young group. The specificity, positive predictive value, and accuracy of the CSA decreased when the CSA cutoff value for the young group was applied to the elderly group. The CSA cutoff values for the elderly group were: CSA supine , 6.92 cm 2 and CSA RLDP , 10.65 cm 2 . The CSA of the empty stomach was greater in elderly patients than in young patients. We suggest that the following CSA cutoff values should be used for predicting pulmonary aspiration risk in elderly patients: CSA supine , 6.92 cm 2 and CSA RLDP , 10.65 cm 2 .

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Ultrasonograficzna ocena wypełnienia żołądka a ryzyko aspiracji treści pokarmowej w okresie okołooperacyjnym

Cited by 11 publications

References 21 publications

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

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

Prevalence and variations in gastric emptying delay in response to GLP‐1 receptor agonist liraglutide

Differences in preoperative gastric ultrasound findings in elderly compared to the mid-aged surgical patients: A retrospective observational study

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