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Ultrasound gastric content

Ziye Zhang, Xiaofeng Zhang, Wei Chen, Peng Zhou
The effects of high intensity ultrasound (HIU) modification (power: 100-800 W, 15 min) on the conformation stability, in vitro digestibility and allergenicity of tropomyosin (TM) from Exopalaemon modestus were investigated. HIU treatment oxidized the Cys, Met and Lys in TM and degraded TM to generate protein fragments by HIU-induced free radicals. The α-helix content decreased, while β-sheet, β-turn and random coil increased. The immunoblotting and ELISA data suggested HIU treatment reduced the allergenicity and contributed to higher digestibility of TM...
April 15, 2018: Food Chemistry
Anahi Perlas, Cristian Arzola, Peter Van de Putte
This narrative review summarizes the current knowledge on point-of-care ultrasound (POCUS) of gastric contents in order to inform an assessment of aspiration risk and guide anesthetic management at the bedside. An I-AIM framework (Indication, Acquisition, Interpretation, and Medical decision-making) is used to summarize and organize the content areas. This narrative review spans the breadth of the literature on pediatric and adult subjects as well as on special patient populations such as obstetric and severely obese individuals...
April 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Mathilde Roukhomovsky, Laurent Zieleskiewicz, Alexandre Diaz, Laurent Guibaud, Kathia Chaumoitre, François-Pierrick Desgranges, Marc Leone, Dominique Chassard, Lionel Bouvet
BACKGROUND: Ultrasound examination of the gastric antrum allows reliable pre-operative assessment of gastric contents and volume in adult patients. However, during pregnancy, the change in the anatomical position of the stomach due to the gravid uterus leads to a change in the measured value of the antral area. Therefore, current mathematical models predicting gastric content volume (GCV) in the adult may not apply in term pregnant women. OBJECTIVE: To propose a mathematical model which is predictive of GCV in pregnant women and to assess the performance of an ultrasound qualitative grading scale (0 to 2) for the diagnosis of clear fluid volumes more than 0...
November 27, 2017: European Journal of Anaesthesiology
Bruno M Pereira, Renato G Pereira, Robert Wise, Gavin Sugrue, Tanya L Zakrison, Alcir E Dorigatti, Rossano K Fiorelli, Manu L N G Malbrain
BACKGROUND: Intra-abdominal hypertension is a common complication in critically ill patients. Recently the Abdominal Compartment Society (WSACS) developed a medical management algorithm with a stepwise approach according to the evolution of the intra-abdominal pressure and aiming to keep IAP ≤ 15 mm Hg. With the increased use of ultrasound as a bedside modality in both emergency and critical care patients, we hypothesized that ultrasound could be used as an adjuvant point-of-care tool during IAH management...
2017: Anaesthesiology Intensive Therapy
Peter van de Putte, Jonathan van Hoonacker, Anahi Perlas
BACKGROUND: Perioperative aspiration leads to significant morbidity and mortality. Standard fasting periods are used to ensure an empty stomach in patients. Anesthesiologists are frequently confronted with cases of dubious adherence to these guidelines. Point-of-care gastric ultrasound is a diagnostic tool that offers information on the type and volume of gastric contents. METHODS: We performed a retrospective analysis of a departmental database containing clinical and sonographic information on elective surgical patients who had been non- compliant to the fasting guidelines...
November 17, 2017: Minerva Anestesiologica
C H F Ferreira, Y Shifrin, J Pan, J Ivanovska, P J McNamara, J Belik
BACKGROUND: Gastric residuals are a common finding in enterally fed preterm neonates and traditionally thought to reflect immaturity-related delayed gastric emptying. Adult human data suggest that the meal volume regulate the gastric emptying rate, but early in life, this has not been adequately evaluated. The goal of this study was to study the rat postnatal changes in gastric emptying rate and the strain-induced effect on muscle contraction. We hypothesized that the stomach content volume and not developmental factors determines the newborn gastric emptying rate, via the Rho-kinase 2 (ROCK-2) pathway...
October 11, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Mohammed Ibrahim, Kissan Gilbert
Adenocarcinoma stands the most common malignancies in the gastric carcinomas and holds a significant mortality and morbidity rates annually, due to the early vague symptoms among the population and hence the delayed presentation at advanced stages of cancer. In India the screening programs for gastric cancer has been a setback due to various logistics reasons and the data available from reporting is also not content. Our study is a review article featuring the management of gastric cancer in the Indian population...
2017: Translational Gastroenterology and Hepatology
F-P Desgranges, A-C Gagey Riegel, C Aubergy, M de Queiroz Siqueira, D Chassard, L Bouvet
Ultrasound examination of the gastric antrum allows reliable assessment of gastric contents and volume. Postoperative assessment of gastric contents before recovery from anaesthesia could help the physician to choose the most appropriate extubation technique after surgery in children. In this prospective observational study, we assessed whether significant changes occurred in gastric contents during the intra-operative period in children undergoing elective ear, nose and throat (ENT) surgery. Children aged between six months and 16 years were recruited consecutively...
November 2017: Anaesthesia
F Vial, N Hime, J Feugeas, N Thilly, P Guerci, H Bouaziz
INTRODUCTION: Pulmonary aspiration of gastric contents in pregnant women undergoing general anesthesia or sedation/analgesia in the peripartum period is a feared complication in obstetric anesthesia. We assessed the changes in antral cross-sectional area (CSA) with ultrasonography in laboring women and in the immediate postpartum period. PATIENTS AND METHODS: In an observational study in a university-affiliated maternity, gastric ultrasonography examinations were performed in non-consecutive laboring women, after epidural analgesia insertion and after childbirth...
August 2017: Acta Anaesthesiologica Scandinavica
Jonathan Kei, Emily E Utschig, Reinier J van Tonder
BACKGROUND: Cricoid pressure during intubation has been used for decades as a way to potentially occlude the esophagus to avoid aspiration of gastric contents. However, recent evidence has questioned the effectiveness of this maneuver. OBJECTIVE: This study uses a noninvasive modality, ultrasonography, to determine the anatomic position of the cricoid cartilage and the esophagus and examines the effectiveness of cricoid pressure on esophageal compression. METHODS: Ultrasound imaging was used to describe the anatomic relationship of the esophagus to the trachea as either being directly behind the trachea, partially behind the trachea, or completely lateral to the trachea...
August 2017: Journal of Emergency Medicine
Flora Margarida Barra Bisinotto, Patrícia Luísa Pansani, Luciano Alves Matias da Silveira, Aline de Araújo Naves, Ana Cristina Abdu Peixoto, Hellen Moreira de Lima, Laura Bisinotto Martins
Objective: Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content. Method: A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal...
February 2017: Revista da Associação Médica Brasileira
C Chen, L Liu, C Y Wang, S-W Choi, V M Yuen
This prospective study was designed to evaluate gastric volume and content in patients with renal failure and healthy controls after an overnight fast, immediately after a light meal and at 6 h after the meal. Thirty subjects in each group were recruited. At each scanning session, gastric antral cross-sectional area was measured in the supine recumbent and right lateral decubitus positions, and a qualitative assessment of gastric contents was made using the Perlas three-point grading system. Six hours after the meal, the mean (SD) antral cross-sectional area in the supine position was 471 (195) mm(2) in patients with renal failure and 319 (106) mm(2) in healthy controls (p = 0...
June 2017: Anaesthesia
R Kruisselbrink, C Arzola, T Jackson, A Okrainec, V Chan, A Perlas
BACKGROUND: Point-of-care gastric ultrasound is an emerging tool to assess gastric content and volume at the bedside. The examination includes both a qualitative and a quantitative component. The aim of this study was to evaluate the performance of an existing model for predicting gastric volume in severely obese subjects (BMI >35 kg m(-2)). METHODS: This observer-blinded experimental study compared the gastric volume predicted based on a sonographically measured cross-sectional area of the gastric antrum with the gastric volume measured by suctioning under gastroscopic guidance in a cohort of severely obese subjects...
January 2017: British Journal of Anaesthesia
Lionel Bouvet, Caroline Augris, Clémence Aubergy, Dominique Chassard
We report two cases of patients presenting for elective surgery, in whom significant gastric contents were identified by performing fortuitous ultrasound examination of their antral area. The first patient presented for a day-case surgery scheduled under regional anesthesia. With his consent, ultrasound examination of the antral area was by chance performed within the context of training for this technique, showing significant solid contents in the stomach. The patient admitted that he had not respected preoperative fasting...
September 2016: Journal of Ultrasonography
Flora Margarida Barra Bisinotto, Aline de Araújo Naves, Hellen Moreira de Lima, Ana Cristina Abdu Peixoto, Gisele Caetano Maia, Paulo Pacheco Resende Junior, Laura Bisinotto Martins, Luciano A Matias da Silveira
BACKGROUND AND OBJECTIVES: The current preoperative fasting guidelines allow fluid intake up to 2hours before surgery. The aim of this study was to evaluate the gastric volume of volunteers after an overnight fast and compare it with the gastric volume 2hours after ingestion of 200 and 500mL of isotonic solution, by means of ultrasound assessment. METHOD: Eighty volunteers underwent gastric ultrasound at three times: after 8hours of fasting; 2hours after ingestion of 200mL isotonic saline, followed by the first scan; and on another day, 2hours after ingestion of 500mL of the same solution after an overnight fast...
July 2017: Revista Brasileira de Anestesiologia
Tadashi Okabe, Hideo Terashima, Atsuhiro Sakamoto
BACKGROUND & AIMS: We previously demonstrated that the gastric emptying rate of liquids chiefly depended on the total amount of calories (energy content) in a uniform volume. The aim of the present study was to examine the effects of different volumes of liquids with a uniform energy content on gastric emptying. METHODS: Three types of test solutions were prepared with a uniform amount of calories (200 kcal provided by glucose) and step-wise increments in volume (200 ml, 400 ml, and 600 ml)...
October 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
C Rouget, D Chassard, C Bonnard, M Pop, F P Desgranges, L Bouvet
Ultrasound measurement of the antral cross-sectional area allows a quantitative estimate of gastric contents in non-pregnant adults, but this relationship may be affected by compression of the stomach exerted by the gravid uterus during pregnancy. This study aimed to assess differences in quantitative (Perlas score) and qualitative (antral cross-sectional area) ultrasound assessments of the gastric antrum performed immediately before and after caesarean section. Forty-three women having elective caesarean section performed under spinal anaesthesia were studied in the semirecumbent and semirecumbent-right lateral positions...
November 2016: Anaesthesia
Achim Schmitz, Alexander R Schmidt, Philipp K Buehler, Thomas Schraner, Melanie Frühauf, Markus Weiss, Richard Klaghofer, Christian J Kellenberger
BACKGROUND: Emergency situations and conditions with impaired gastric emptying enhance the risk of perioperative pulmonary aspiration due to increased residual gastric contents volume (GCV). Gastric ultrasonographic (US) measurement of the gastric antral cross-sectional area (CSA) has been proposed to estimate preanesthetic GCV. However, only few healthy children and fasted pediatric patients have been investigated so far, predicting GCV with considerable imprecision. This study aimed to compare GCV assessed by US in different patient positions for measuring CSA, using magnetic resonance imaging (MRI) as reference, and to evaluate its potential as diagnostic test...
December 2016: Paediatric Anaesthesia
Naseem Mirbagheri, Graham Dunn, Vasikaran Naganathan, Michael Suen, Marc A Gladman
BACKGROUND: GI dysfunction is common after abdominal surgery. However, assessment and diagnosis currently lack objective measurement. OBJECTIVE: The purpose of this study was to evaluate the feasibility and clinical use of bedside sonographic assessment of gastric emptying by measuring the time to complete emptying of a standard volume of ingested water in patients after colorectal surgery. DESIGN: This was a prospective cohort study. SETTINGS: The study was conducted at a single tertiary institution in Sydney...
August 2016: Diseases of the Colon and Rectum
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June 2016: Annals of Intensive Care
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