Ultrasound assessment of gastric volume in children after drinking carbohydrate-containing fluids

Song, In Kyung; Kim, Seungman; Lee, J.-H.; Kim, E.-H.; Kim, J.-T.

doi:10.1093/bja/aew031

Cited by 52 publications

(58 citation statements)

References 37 publications

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“…Multiple studies, using various methodologies, have reported a linear correlation between antral cross‐sectional area and gastric volume, with correlation coefficients ranging from 0.6 to 0.91 . Using a similar approach of controlled fluid ingestion to our current study, but with only two volumes of 250 ml and 500 ml, Perlas et al showed a correlation coefficient of 0.86 .…”

Section: Discussionsupporting

confidence: 72%

Gastric ultrasound in the third trimester of pregnancy: a randomised controlled trial to develop a predictive model of volume assessment

et al. 2017

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SummaryBedside gastric ultrasonography can be performed reliably by anaesthetists to assess gastric content in the peri-operative period. We aimed to study the relationship between gastric cross-sectional area, assessed by ultrasound, and volumes of clear fluids ingested by pregnant women. We recruited 60 non-labouring third-trimester pregnant women in a randomised controlled and assessor-blinded study. A standardised scanning protocol of the gastric antrum was performed in the 45°semirecumbent and 45°semirecumbent-right lateral positions. Subjects were randomly allocated to drink one out of six predetermined volumes of apple juice (0 ml, 50 ml, 100 ml, 200 ml, 300 ml, 400 ml). Qualitative and quantitative assessments at a baseline period after an 8-h fast, and immediately after the drink, were used to establish the correlation between antral cross-sectional area and volume ingested. A predictive model to estimate gastric volume was developed. Antral cross-sectional area in the semirecumbent right lateral position significantly correlated with the ingested volume (Spearman rank correlation = 0.7; p < 0.0001). A cut-off value of 9.6 cm 2 discriminated ingested volumes ≥ 1.5 ml.kg À1 with a sensitivity of 80%, a specificity of 66.7%, and an area under the curve of 0.82. A linear predictive model was developed for gastric volume based only on antral cross-sectional area (Volume (ml) = À327.1 + 215.2 9 log (cross-sectional area) (cm 2 )). We conclude that in pregnant women in the third trimester of gestation, the antral cross-sectional area correlates well with volumes ingested, and this cut-off value in the semirecumbent right lateral position discriminates high gastric volumes.

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Section: Discussionsupporting

confidence: 72%

Gastric ultrasound in the third trimester of pregnancy: a randomised controlled trial to develop a predictive model of volume assessment

et al. 2017

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“…Ultrasound assessment in children confirms that 10–15 ml.kg −1 clear fluids given 2 h pre‐operatively results in a reduction rather than an increase in antral volume by the time of induction .…”

Section: Childrenmentioning

confidence: 77%

“…Promising emerging areas of study in paediatrics are the use of a bed‐side ultrasound to ascertain residual gastric contents , perhaps as a potential tool in modifying the induction technique in the emergency setting . We have come a long way since the nil‐from‐midnight days, but there is still much more refinement to the pre‐operative fasting process to be done.…”

Section: Childrenmentioning

confidence: 99%

Pre‐operative fasting in adults and children: clinical practice and guidelines

2018

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Summary It is widely recognised that prolonged fasting for elective surgery in both children and adults serves no purpose, adversely affects patient well‐being and can be detrimental. Although advised fasting times for solids remain unchanged, there is good evidence to support a 1‐h fast for children, with no increase in risk of pulmonary aspiration. In adults, a major focus has been the introduction of carbohydrate loading before anaesthesia, so that patients arrive for surgery not only hydrated but also in a more normal metabolic state. The latter attenuates some of the physiological responses to surgery, such as insulin resistance. As in children, there is no increase in risk of pulmonary aspiration. Further data are required to guide best practice in patients with diabetes.

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“…10 In addition, such carbohydrate loading may help to reduce thirst, hunger, and anxiety. 11 Initial promising reports using high-carbohydrate beverages in children are published, 12 but investigations where gastric content is directly measured are not available. Therefore, we designed a randomised controlled trial to assess how a commercially available carbohydrate beverage, labelled as a dietary supplement for preoperative oral administration, would affect the gastric contents and various parameters of perioperative discomfort in children subjected to general anaesthesia.…”

Section: Editor's Key Pointsmentioning

confidence: 99%

Randomised controlled trial comparing preoperative carbohydrate loading with standard fasting in paediatric anaesthesia

Tudor-Drobjewski

Marhofer

Kimberger

et al. 2018

British Journal of Anaesthesia

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Ultrasound assessment of gastric volume in children after drinking carbohydrate-containing fluids

Abstract: cris.nih.go.kr (KCT0001546).

Cited by 52 publications

References 37 publications

Gastric ultrasound in the third trimester of pregnancy: a randomised controlled trial to develop a predictive model of volume assessment

Gastric ultrasound in the third trimester of pregnancy: a randomised controlled trial to develop a predictive model of volume assessment

Pre‐operative fasting in adults and children: clinical practice and guidelines

Randomised controlled trial comparing preoperative carbohydrate loading with standard fasting in paediatric anaesthesia

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