1. Gastric point-of-care ultrasonography in patients undergoing radical gastrointestinal surgery before anesthetic induction: an observational cohort study
- Author
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Siming Huang, Shumei Cao, Xia Sun, and Jun Zhang
- Subjects
Pulmonary aspiration ,Gastric point-of-care ultrasound ,Gastric antrum ,Gastric content ,Gastrointestinal cancer ,Anesthesiology ,RD78.3-87.3 - Abstract
Abstract Background Pulmonary aspiration of gastric contents is a serious perioperative complication. Patients with gastric cancer may experience delayed gastric emptying. However, the role of qualitative and quantitative gastric ultrasound assessments in this patient population before anesthesia induction has not yet been determined. Methods Adult patients with gastrointestinal cancer were recruited and examined using gastric point-of-care ultrasound (POCUS) before anesthetic induction from March 2023 to August 2023 in a tertiary cancer center. Three hundred patients with gastric cancer were conducted with POCUS prior to induction, and three hundred patients with colorectal cancer were included as controls. The cross-sectional area (CSA) of the gastric antrum and gastric volumes (GV) were measured and calculated. We determined the nature of the gastric contents and classified the antrum using a 3-point grading system. A ratio of GV to body weight > 1.5mL/Kg was defined as a high risk of aspiration. Results In patients with gastric cancer, 70 patients were classified as grade 2 (23%, including 6 patients with solid gastric contents) and 63 patients (21%) were identified as having a high risk of aspiration. Whereas in patients with colorectal cancer, only 11 patients were classified as grade 2 (3.7%), and 27 patients (9.7%) were identified as having a high risk of aspiration. A larger tumor size (OR:1.169, 95% CI 1.045–1.307, P = 0.006), tumor located in antrum (OR:2.304, 95% CI 1.169–4.539,P = 0.016), gastrointestinal obstruction (OR:21.633, 95% CI 4.199–111.443, P
- Published
- 2024
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