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Clinical Assessment of the Ultrasonographic Measurement of Antral Area for Estimating Preoperative Gastric Content and Volume.
MedLine Citation:
PMID:  21364462     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND:: This prospective observational study aimed to assess the feasibility and performance of the ultrasonographic measurement of antral cross-sectional area (CSA) for the preoperative assessment of gastric contents and volume in adult patients and for the diagnosis of risk stomach (defined by the presence of solid particles and/or gastric fluid volume >0.8 ml/kg). METHODS:: A preoperative ultrasonographic measurement of the antral CSA was performed for each patient by a physician (L.B.) blinded to the history of the patient. Immediately after tracheal intubation, an 18-French multiorifice Salem tube was inserted and gastric contents were aspirated in five different patient positions; during this time, the patient's epigastrium was massaged and the tube was moved backward and forward in the stomach. The relationship between the antral area and the volume of aspirated gastric contents was analyzed, as was the performance of ultrasonographic measurement of antral area for the diagnosis of risk stomach. RESULTS:: The measurement of antral CSA was performed on 180 of 183 patients. A significant positive relationship between antral CSA and aspirated fluid volume was found. The cutoff value of antral CSA of 340 mm for the diagnosis of risk stomach was associated with a sensitivity of 91% and a specificity of 71%. The area under the receiver operating characteristic curve for the diagnosis of risk stomach was 90%. CONCLUSIONS:: The ultrasonographic measurement of antral CSA could be an important help for the anesthesiologist in minimizing the risk of pulmonary aspiration of gastric contents due to general anesthesia.
Authors:
Lionel Bouvet; Jean-Xavier Mazoit; Dominique Chassard; Bernard Allaouchiche; Emmanuel Boselli; Dan Benhamou
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-28
Journal Detail:
Title:  Anesthesiology     Volume:  -     ISSN:  1528-1175     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-3-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  1300217     Medline TA:  Anesthesiology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
* Staff Anesthesiologist, University of Lyon, Claude Bernard Lyon 1, INSERM UMR 865, and Department of Anesthesia and Intensive Care, Édouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; ∥ Staff Anesthesiologist, § Professor of Anesthesiology, University of Lyon, Claude Bernard Lyon 1, and Department of Anesthesia and Intensive Care, Édouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France; ‡ Professor of Anesthesiology, University of Lyon, Claude Bernard Lyon 1, and Department of Anesthesia and Intensive Care, Femme Mère Enfant Hospital, Hospices Civils de Lyon, Bron, France; † Staff Anesthesiologist, # Professor of Anesthesiology, Paris-Sud University and Department of Anesthesia and Intensive care, University Hospital of Bicêtre, Assistance Publique - Hôpitaux de Paris, Le Kremlin-Bicêtre, France.
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