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Gastric content ultrasound

David C Mackenzie, Aftab M Azad, Vicki E Noble, Andrew S Liteplo
OBJECTIVE: We sought to determine test performance characteristics of emergency physician ultrasound for the identification of gastric contents. METHODS: Subjects were randomized to fast for at least 10 h or to consume food and water. A sonologist blinded to the patient's status performed an ultrasound of the stomach 10 min after randomization and oral intake, if applicable. The sonologist recorded their interpretation of the study using three sonographic windows...
January 2019: American Journal of Emergency Medicine
Garima Sharma, Rebecca Jacob, Subramanyam Mahankali, M N Ravindra
Background and Aims: Pulmonary aspiration of gastric contents is a serious complication of anaesthesia. The aim of this study was to determine, with the help of ultrasound, the gastric volume and content in fasted patients presenting for elective surgeries and correlate the results with fasting times and co-morbidities of the patients. Methods: The study was conducted in 100 adult patients presenting for elective surgery. A preoperative bedside gastric ultrasound scan was done in supine and right lateral position...
October 2018: Indian Journal of Anaesthesia
Sadhvi Sharma, Alka Sachin Deo, Padmalatha Raman
Background and Aims: An audit was conducted between July 2017 and November 2017 to assess the adequacy of American Society of Anesthesiologists (ASA) fasting guidelines on 246 patients by means of gastric ultrasonography (USG). The relevance of this audit is that many of our patients have one or more risk factors for aspiration such as diabetes mellitus, chronic kidney disease (CKD), gastro-oesophageal reflux disease (GERD), and obesity. Methods: This audit was a prospective observational study which included all patients posted for surgery within the audit period...
October 2018: Indian Journal of Anaesthesia
Arumugam Vasudevan, Suganya Srinivasan, Stalin Vinayagam, Govindarajalou Ramkumar, Muthapillai Senthilnathan
Background: Rapid sequence induction and intubation (RSII) with application of "Cricoid pressure" and avoidance of "facemask ventilation" (FMV) is believed to minimize the risk of pulmonary aspiration of gastric contents during general anesthesia. However, some patients may be at risk of developing hypoxemia and may benefit from FMV during RSII. The purpose of this study was to assess the effectiveness of "cricoid pressure" in preventing gastric insufflation during FMV using gastric ultrasonography...
October 2018: Saudi Journal of Anaesthesia
Julie Leviter, Dale W Steele, Erika Constantine, James G Linakis, Siraj Amanullah
OBJECTIVES: 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 2-17 years fasting prior to procedural sedation. A single sonographer scanned each patient's gastric antrum in 2 positions: supine with the upper body elevated (SUBE) and right lateral decubitus (RLD)...
October 29, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Xiubin Chen, Fenghua Chen, Qingsong Zhao, Lina Zhang, Zhiqiang Liu
STUDY OBJECTIVE: To calculate the stomach volume according to the antral area in pregnant women. DESIGN: Prospective observational study. SETTING: One of the maternity units in our hospital. PATIENTS: 24 singleton pregnancy women, over 18-year-old, non-laboring, gestational age ≥ 36 weeks, ASA physical status I to II were involved in our study. INTERVENTIONS AND MEASUREMENTS: An ultrasound assessment of the antrum was performed to the pregnant women after 8 hours fasting for the first time...
October 18, 2018: Journal of Clinical Anesthesia
Wojciech Gola, Michał Domagała, Adam Cugowski
The risk of aspiration of gastric contents in the perioperative period constitutes a serious clinical problem and it is connected with increased mortality. At present, the risk of aspiration is assessed only on the basis of an interview and information obtained from the patient. Such assessment is not always reliable while the concomitance of some additional factors influencing the delay of gastric emptying significantly decreases its sensitivity. Using bedside ultrasound imaging in an assessment of gastric contents is a method which supports an objective, simple and quick assessment of the risk of aspiration, helps one to optimise perioperative anaesthetic management, and should constitute a routine element of the perioperative patient assessment...
2018: Anaesthesiology Intensive Therapy
Bruno Mendes Carmona, Clauber Claudino Alves Almeida, Waldônio de Brito Vieira, Mario de Nazareth Chaves Fascio, Lídia Raquel de Carvalho, Luiz Antonio Vane, Fabiano Timbó Barbosa, Paulo do Nascimento Junior, Norma Sueli Pinheiro Módolo
BACKGROUND: Adequate preoperative fasting is critical in preventing pulmonary aspiration of gastric content. We proposed to study the sonographic gastric content dynamics after the ingestion of liquid or solid food in healthy volunteers and confront it with current guidelines for preoperative fasting times. METHODS: We performed a prospective, crossover, evaluator-blinded study involving 17 healthy volunteers of both sexes. Each participant fasted for 10h and was subjected to a baseline gastric ultrasound, intake of 400mL of coconut water or a 145g, 355kcal meat sandwich, and sonographic gastric evaluations after 10min and every hour until the stomach was completely empty...
November 2018: Revista Brasileira de Anestesiologia
François-Pierrick Desgranges, Marine Simonin, Sophie Barnoud, Laurent Zieleskiewicz, Eloise Cercueil, Julien Erbacher, Bernard Allaouchiche, Dominique Chassard, Lionel Bouvet
BACKGROUND: Emergent obstetrical procedures may require general anaesthesia in parturients at full cervical dilatation or immediately after vaginal birth. This study aimed to determine the prevalence and the predictive factors of higher estimated gastric content in parturients at full cervical dilatation with epidural analgesia and allowed to drink during the labour, and to assess the ability of the antral area measured in the semirecumbent position (SR-CSA) to identify higher estimated gastric content in this setting...
August 7, 2018: Acta Anaesthesiologica Scandinavica
Stephen C Haskins, Richelle Kruisselbrink, Jan Boublik, Christopher L Wu, Anahi Perlas
This article in our series on point-of-care ultrasound (US) for the regional anesthesiologist and pain management specialist describes the emerging role of gastric ultrasonography. Although gastric US is a relatively new point-of-care US application in the perioperative setting, its relevance for the regional anesthesiologist and pain specialist is significant as our clinical practice often involves providing deep sedation without a secured airway. Given that pulmonary aspiration is a well-known cause of perioperative morbidity and mortality, the ability to evaluate for NPO (nil per os) status and risk stratify patients scheduled for anesthesia is a powerful skill set...
October 2018: Regional Anesthesia and Pain Medicine
L Zieleskiewicz, L Bouvet, S Einav, G Duclos, M Leone
Complications during pregnancy are not frequent, but may occur abruptly. Point-of-care ultrasound is a non-invasive, non-ionising diagnostic tool that is available at the bed-side when complications occur. This review covers the use of ultrasound in various clinical situations. Gastric ultrasound can identify stomach contents that put the woman at risk for pulmonary aspiration. In the future, this tool will probably be used routinely before induction of anaesthesia to determine the presence of stomach contents above a particular risk threshold...
October 2018: Anaesthesia
D Lee, A J Czech, M Elriedy, A Nair, K El-Boghdadly, I Ahmad
Cricoid pressure is employed during rapid sequence induction to reduce the risk of pulmonary aspiration. Correct application of cricoid pressure depends on knowledge of neck anatomy and precise identification of surface landmarks. Inaccurate localisation of the cricoid cartilage during rapid sequence induction risks incomplete oesophageal occlusion, with potential for pulmonary aspiration of gastric contents. It may also compromise the laryngeal view for the anaesthetist. Accurate localisation of the cricoid cartilage therefore has relevance for the safe conduct of rapid sequence induction...
October 2018: Anaesthesia
Pooja Devi, Sandeep Rathor, Pratibha Sharma, Jyotsna Sen, Harmeet Kaur, Jasbir Singh
In the present study, the salbutamol sulfate-loaded sodium alginate-pectin (SS-loaded SA-PEC) bubble beads have been optimized and evaluated for drug loading, in vitro drug release, in vivo floating behavior in the stomach, etc. Nine batches (F1-F9) of bubble beads with different SA and PEC contents were prepared by novel co-axial needle air-injection method and related to their percent drug loading efficiency (%DLE) and percent drug release at 4 h (%R4h ) as response factors. The multivariate analysis has shown the effect of SA/PEC ratio, total polymer content, as well as their interaction on %DLE and %R4h ...
September 15, 2018: European Journal of Pharmaceutical Sciences
Sher-Lu Pai, Elird Bojaxhi, Ilana I Logvinov, Steven B Porter, Neil G Feinglass, Christopher B Robards, Klaus D Torp
Gastric ultrasound is emerging as a tool that can be used to assess gastric content and volume in patients with an unknown fasting history. This information can impact the choice of anesthetic technique or the timing of surgery due to the presumed risk of aspiration. Currently, no data are available regarding the use of gastric ultrasound for patients who have had prior gastric operations, despite the increasing number of patients undergoing bariatric surgery. Our experience suggests that a patient with a prior Roux-en-Y gastric bypass may present with altered anatomy, rendering gastric ultrasound an ineffective technique to assess the volume of ingested food or liquid...
July 5, 2018: A&A practice
Yuanqing He, Lingling Shen, Chaoyue Ma, Min Chen, Ye Pan, Lijing Yin, Jie Zhou, Xiaochun Lei, Qian Ren, Yuqing Duan, Haihui Zhang, Haile Ma
Background : Dietary proteins are known for their wide range of nutritional, functional and biological properties. Although the total amount of proteins may be obtained from mixtures, its "availability" for absorption in the gut is in many cases quite uncertain or even varies for the same food depending on processing conditions, the presence of other components, and so on. Methods : To obtain accurate protein hydrolysate absorption data, we have developed a small intestine model (SIM) to test them...
June 29, 2018: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
Louai R Zaidan, Elhaitham K Ahmed, Bachar Halimeh, Yasser Radwan, Khalil Terro
BACKGROUND: Chylous ascites is considered to be an intra-abdominal collection of creamy colored fluid with triglyceride content of > 110 mg/dL. Chylous ascites is an uncommon but serious complication of numerous surgical interventions. However, it is a rare complication of LRYGB. An internal hernia limb defect is thought to be the underlying etiology, where the hernia will cause lymphatic vessel engorgement and lymphatic extravasation. CASE PRESENTATION: We report a case of a 29 years old male with a 9 year history of laparoscopic Roux en y gastric bypass (LRGYB), presenting with recurrent abdominal pain for 2 months radiating to the right shoulder...
June 19, 2018: BMC Surgery
Priya Vijayvargiya, Sina Jameie-Oskooei, Michael Camilleri, Victor Chedid, Patricia J Erwin, Mohammad Hassan Murad
BACKGROUND: The relationship between delayed gastric emptying and upper GI symptoms (UGI Sx) is controversial. OBJECTIVE: To assess association between gastric emptying and UGI Sx, independent of treatment. DESIGN: We performed a systematic review and meta-analysis of the literature from 2007 to 2017, review of references and additional papers identified by content expert. We included studies evaluating the association between gastric emptying and nausea, vomiting, early satiety/postprandial fullness, abdominal pain and bloating...
June 2, 2018: Gut
Yan-Mei Feng, Dong Wan, Rui Guo
RATIONALE: Critical care ultrasound identifies the signs of free intraperitoneal air and echogenic free fluid always indicates hollow viscus perforation (HVP) and needs immediate surgical interventions. However, in rare cases, these classic signs may also mislead proper clinical decisions. We report perforated viscus associated large peritoneal effusion with initial critical care ultrasound findings, whereas computed tomography (CT) examination confirmed a giant stomach due to superior mesenteric artery syndrome (SMAS)...
May 2018: Medicine (Baltimore)
Uma R Parekh, Niraja Rajan, Robyn C Iglehart, Patrick M McQuillan
Ultrasound assessment of gastric contents and volume is gaining popularity in adults and children. At present, a preoperative verbal check is used to determine the fasting status. Due to fear of delay or cancellation of surgery, parents may not disclose noncompliance with fasting guidelines. Pulmonary aspiration of gastric contents is a potential cause of morbidity and mortality. Ultrasound assessment of gastric contents is noninvasive and easy to learn. We present a series of three cases to demonstrate how the use of ultrasound to assess gastric contents in children can provide an objective means for decision-making and impact anesthetic management when preoperative fasting status is uncertain...
April 2018: Saudi Journal of Anaesthesia
Richelle Kruisselbrink, Angineh Gharapetian, Luis E Chaparro, Noam Ami, Dustin Richler, Vincent W S Chan, Anahi Perlas
BACKGROUND: Pulmonary aspiration of gastric contents is associated with significant perioperative morbidity and mortality. Previous studies have investigated the validity, reliability, and possible clinical impact of gastric ultrasound for the assessment of gastric content at the bedside. In the present study, we examined the accuracy (evaluated as sensitivity, specificity, and likelihood ratios) of point-of-care gastric ultrasound to detect a "full stomach" in a simulated scenario of clinical equipoise...
April 5, 2018: Anesthesia and Analgesia
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