Prediction of gastric fluid volume by ultrasonography in infants undergoing general anaesthesia.
Br J Anaesth
; 127(2): 275-280, 2021 08.
Article
em En
| MEDLINE
| ID: mdl-34045064
ABSTRACT
BACKGROUND:
Point-of-care ultrasonography can estimate gastric contents and volume to assess the risk of pulmonary aspiration; however, its use in infants has not been well validated. We aimed to develop a predictive model for estimating gastric fluid volume using ultrasonography in infants.METHODS:
This prospective observational study enrolled 200 infants (≤12 months) undergoing general anaesthesia. After anaesthetic induction, while preserving spontaneous respiration, we measured gastric antral cross-sectional area using ultrasonography in both the supine and right lateral decubitus positions. We then suctioned the gastric content and measured its volume. The primary outcome was development of a gastric fluid volume prediction model with multiple regression analysis. Agreement between the predicted volume and the suctioned volume was evaluated using a Bland-Altman plot.RESULTS:
Overall, 192 infants were included in the final analysis. Pearson correlation analysis showed that the gastric antral cross-sectional area in the supine (P<0.001; correlation coefficient 0.667) and right lateral decubitus (P<0.001; correlation coefficient 0.845) positions and qualitative antral grade (P<0.001; correlation coefficient 0.581) correlated with suctioned volume. We developed a predictive model predicted volume (ml)=-3.7+6.5 × (right lateral decubitus cross-sectional area [cm2])-3.9 (supine cross-sectional area [cm2])+1.7 × grade (P<0.01). When comparing the predicted volume and suctioned volume, the mean bias was 0.01 ml kg-1 and the limit of agreement was -0.58 to 0.62 ml kg-1.CONCLUSIONS:
Gastric fluid volume can be estimated using a predictive model based on ultrasonography data in infants. CLINICAL TRIAL REGISTRATION NCT03155776.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ultrassonografia
/
Aspiração Respiratória
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Conteúdo Gastrointestinal
/
Anestesia Geral
Tipo de estudo:
Diagnostic_studies
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Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Female
/
Humans
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Infant
/
Male
Idioma:
En
Revista:
Br J Anaesth
Ano de publicação:
2021
Tipo de documento:
Article
País de publicação:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM