Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Ultrasonographic Evaluation of Gastric Content and Volume in Elective Pediatric Patients: A Prospective Observational Study

Asiye Demirel
* ORCID logo ,
Şeyda Efsun Özgünay
,
Şermin Eminoğlu
,
Ayşe Neslihan Balkaya
,
Tuğba Onur
ORCID logo ,
Nermin Kılıçarslan
,
Mehmet Gamlı
Version 1 : Received: 21 June 2023 / Approved: 21 June 2023 / Online: 21 June 2023 (09:54:17 CEST)

A peer-reviewed article of this Preprint also exists.

Demirel, A.; Özgünay, Ş.E.; Eminoğlu, Ş.; Balkaya, A.N.; Onur, T.; Kılıçarslan, N.; Gamlı, M. Ultrasonographic Evaluation of Gastric Content and Volume in Pediatric Patients Undergoing Elective Surgery: A Prospective Observational Study. Children 2023, 10, 1432. Demirel, A.; Özgünay, Ş.E.; Eminoğlu, Ş.; Balkaya, A.N.; Onur, T.; Kılıçarslan, N.; Gamlı, M. Ultrasonographic Evaluation of Gastric Content and Volume in Pediatric Patients Undergoing Elective Surgery: A Prospective Observational Study. Children 2023, 10, 1432.

Abstract

Pulmonary aspiration is a serious anaesthetic complication with morbidity and up to 9% of all anaesthesia-related mortality. Aspiration risk is especially focused on fastening time. We aimed to evaluate the prevalence of 'risky stomach' defined by ultrasound imagine of solid contents and/or calculated gastric fluid volume >1.25 mL/kg in elective surgery also comparing this definition with the 0-2 qualitative rating scale used for "empty/risky stomach". This prospective study has 97 patients aged 2-18. Ultrasonographic evaluations of the gastric antrum content is scaled with qualitative assessment in supine and right lateral decubitus (RLD) position. Gastric volume was calculated. In our study, stomach content and volume were evaluated by ultrasound in 97% of children and 5.2% had Grade 2 antrum. In RLD position, antral CSA was 2.36 cm², and the median gastric volume was 0.46 mL/kg. In patients with grade 0 antrum has moderate and positive correlation between antral CSA and BMI, and strong and positive correlation between antral CSA and age like grade 1 antrum. We showed that 0.1%-4.7% of elective children had gastric fluid volumes of >1.25 mL/kg as "risky stomach". Ultrasound for gastric contents could be used routine practice to determine pulmonary aspiration risk in emergency and elective procedures.

Keywords

Pulmonary aspiration; gastric ultrasound; antrum; gastric volume; elective surgery

Subject

Medicine and Pharmacology, Anesthesiology and Pain Medicine

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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