Validity of ultrasonographic measurement of gastric volume in fasted pediatric patients without sedation

Fukunaga, Chikako; Sugita, Michiko; Yamamoto, Tatsuo

doi:10.1007/s00540-016-2204-3

Cited by 9 publications

(11 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies have excluded patients who were crying given the concern that this leads to gaseous gastric distension. 9…”

Section: Discussionmentioning

confidence: 99%

“…We used the right lateral decubitus (RLD) view of the gastric antrum to assess gastric volume, a standard POCUS technique published in previous studies. 1,8,9 We used a validated pediatric formula to calculate gastric volume: [Volume (mL) = −7.8 + (3.5 Â RLD CSA) + (0.127) Â age (months)], where antral CSA is calculated as follows: (CSA = (Anterior-Posterior [AP] Â Craniocaudal [CC] Â π)/4). 8 After the examination was performed, the duration of the POCUS protocol was obtained using the time stamp from the first to the last image obtained by the sonologist.…”

Section: Study Populationmentioning

confidence: 99%

“…We set the lower age limit at 4 years based on data, suggesting that it is more difficult to obtain gastric measurements in patients younger than 4 years. 9 Patients were excluded if they (1) had prior abdominal or esophageal surgery, (2) had a diagnosis of gastroparesis, (3) reported emesis since their last oral intake, (4) were receiving medications known to enhance gastric emptying, or (5) were receiving medications known to prolong gastric emptying. 10 Despite the known impact of opiate pain medications on gastric emptying, patients receiving opioids were included as opioids are often administered as part of the treatment of traumatic injuries.…”

Section: Study Populationmentioning

confidence: 99%

See 2 more Smart Citations

Does Point-of-Care Gastric Ultrasound Correlate With Reported Fasting Time?

et al. 2020

View full text Add to dashboard Cite

Objective: Traditionally, patient-reported fasting time has been the primary objective presedation measure of aspiration risk. Recently, gastric ultrasound has been used to assess gastric volume for the determination of aspiration risk in patients undergoing anesthesia in the operative setting. We sought to determine the correlation of gastric volume estimated by point-of-care ultrasound (POCUS) to reported fasting time. Methods:We included children 4 to 18 years of age who presented with an acute traumatic injury. Enrolled children underwent POCUS to calculate gastric volume, which was calculated using a validated formula: Volume (mL) = −7.8 + (3.5 Â Cross-sectional Area [CSA]) + (0.127 Â Age in months). The CSA was measured (CSA = (anterior-posterior diameter Â craniocaudal diameter Â π)/4). We analyzed the relationship between time since last reported oral intake and measured gastric volume using Spearman rank correlation (ρ).Results: A total of 103 patients with a median age of 10.5 years (interquartile range, 7.3-13.7 years) were enrolled. The gastric antrum was identified and measured in 88 (85%) patients; air obstructing the posterior surface of the gastric antrum prevented measurement in 14 of the 15 remaining patients. We observed a weak inverse correlation between fasting time (either liquid or solid) and estimated gastric volume (ρ = −0.33), with no significant difference based on type of intake (solids, ρ = 0.28; liquids, ρ = 0.22). Conclusion:Gastric volume can be estimated by POCUS and is not strongly correlated with fasting time in children in the emergency department setting.

show abstract

“…Previous studies have excluded patients who were crying given the concern that this leads to gaseous gastric distension. 9…”

Section: Discussionmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

Section: Study Populationmentioning

confidence: 99%

See 1 more Smart Citation

Does Point-of-Care Gastric Ultrasound Correlate With Reported Fasting Time?

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Prior studies in both adults and children have used POCUS to identify liquid or solid contents and to assess gastric volume . We adopted the Perlas scale, which combines a qualitative description of stomach contents (empty, liquid, solids) and quantitative gastric volume estimated from antral cross‐sectional area (CSA) . The Perlas category labels are ordered by “risk of aspiration,” reflecting their intended application in the preoperative setting, as applied to healthy pediatric patients who have fasted for elective surgery.…”

mentioning

confidence: 99%

“Full Stomach” Despite the Wait: Point‐of‐care Gastric Ultrasound at the Time of Procedural Sedation in the Pediatric Emergency Department

Leviter

Steele

Constantine

et al. 2018

Academic Emergency Medicine

View full text Add to dashboard Cite

Objectives:The objective was to use gastric point-of-care ultrasound (POCUS) to assess gastric contents and volume, summarize the prevalence of "full stomach," and explore the relationship between fasting time and gastric contents at the time of procedural sedation.Methods: This was a prospective study of patients aged 2 to 17 years fasting prior to procedural sedation. A single sonographer scanned each patient's gastric antrum in two positions: supine with the upper body elevated and right lateral decubitus (RLD). Gastric content (empty, liquid, or solid) was noted, and the gastric volume (mL/ kg) was estimated from antral cross-sectional area (CSA). "Full stomach" was defined as any solid content or >1.2 mL/kg of liquid gastric content.Results: We enrolled 116 subjects, with a median fasting time of 5.8 hours. Of the 107 with evaluable images, 74 patients, 69% (95% confidence interval [CI] = 60%-77%), were categorized as having a full stomach. Each hour of fasting was associated with lower odds (odds ratio = 0.79, 95% CI = 0.65-0) of a full stomach. However, the knowledge of fasting time alone provides little ability to discriminate between risk groups (C-index = 0.66).Conclusions: Gastric POCUS classified many patients as having a full stomach at the time of expected procedural sedation, despite prolonged fasting times. These findings may inform risk-benefit considerations when planning the timing and medication choice for procedural sedation.

show abstract

“…The ultrasound images were acquired under the sagittal view using the abdominal aorta, superior mesenteric artery, liver, and pancreas as anatomical indicators [26]. The characteristics of the stomach contents were described by the Perlas scale, which combines a qualitative description of stomach contents as "empty", "liquid", "solid", and a quantitative gastric volume estimated from the antral cross-sectional area (CSA) [27][28][29][30]. The CSA of the gastric antrum was evaluated by tracking the serous layer's periphery using a manual caliper (Fig.…”

Section: The Study Protocol and Data Collectionmentioning

confidence: 99%

Gastric point-of-care ultrasound evaluation in pediatric emergency department procedural sedation patients; is the stomach empty at the point of scheduled revisit?

2021

View full text Add to dashboard Cite

Objectives: This study aimed to use gastric point of care ultrasound (POCUS) to estimate the prevalence of an “empty stomach” among patients undergoing procedural sedation and analgesia (PSA) in the emergency department (ED) after observing the requisite fasting time at home. Methods: A prospective observational study was conducted with children with facial lacerations who made a scheduled revisit to the ED after completion of the recommended fasting time. Their stomach contents were assessed with a sagittal view of the gastric antrum by POCUS in the right lateral decubitus position. The characteristics of gastric contents were described as empty, solid, and liquid with an estimated gastric volume. “Empty stomach” was defined as a collapsed gastric antrum or calculated a gastric fluid volume of less than or equal to 1.25 mL/kg on POCUS. Results: Gastric POCUS was performed in 125 patients, and the final analysis included 122 patients. For 95 patients who had followed the recommended fasting time, the median fasting time was 7 hours for solids and 6 hours for liquids, and 78 (82%) patients had an empty stomach. Conversely, seven of 27 patients (26%) who did not have an adequate fasting time had an empty stomach. The optimal cut-off value of fasting time to predict an empty stomach was 6.5 hours based on a receiver operating characteristic (ROC) analysis (sensitivity = 0.767, specificity = 0.811). Conclusions: Most scheduled revisiting children had an “empty stomach” at the time of sedation after the recommended fasting. However, providers should be aware that one in five children still had stomach residue, although they had more than 6 hours of fasting.

show abstract

Validity of ultrasonographic measurement of gastric volume in fasted pediatric patients without sedation

Cited by 9 publications

References 15 publications

Does Point-of-Care Gastric Ultrasound Correlate With Reported Fasting Time?

Does Point-of-Care Gastric Ultrasound Correlate With Reported Fasting Time?

“Full Stomach” Despite the Wait: Point‐of‐care Gastric Ultrasound at the Time of Procedural Sedation in the Pediatric Emergency Department

Gastric point-of-care ultrasound evaluation in pediatric emergency department procedural sedation patients; is the stomach empty at the point of scheduled revisit?

Contact Info

Product

Resources

About