Does Ultrasonographic Measurement of Gastric Content Influence Airway Management Decisions?

Journal Article (Journal Article)

The presence of gastric content before induction of general anesthesia is the primary modifiable risk factor in the prevention of pulmonary aspiration. The purpose of this project was to determine if ultrasonography could be routinely used to measure gastric content and assign aspiration risk in patients undergoing general anesthesia. Preoperative gastric ultrasonography was performed in a convenience sample of 100 patients. A group of Certified Registered Nurse Anesthetists, anesthesia residents, and anesthesiologists were asked their plan for airway management before and after receiving the results of the patients' gastric ultrasonogram, to determine if the scan would alter the plan. In 14% of patients scanned, solid gastric content was observed, 7% had clear liquids present, and 79% had an empty stomach. Of the patients with clear liquids present, 3 had substantial (> 100 mL) gastric content despite following fasting guidelines. Overall, there was a 9% change in airway management from standard induction: 6% changed to modified rapid sequence intubation (no ventilation, no cricoid pressure), and 3% changed to rapid sequence intubation with cricoid pressure. The number of changes to the airway management plan and identification of several patients with substantial gastric content demonstrate the value of preoperative gastric ultrasonography in airway management decision making.

Full Text

Duke Authors

Cited Authors

  • Cieslak, JR; Rice, AN; Gadsden, JC; Vacchiano, CA

Published Date

  • April 2020

Published In

  • Aana J

Volume / Issue

  • 88 / 2

Start / End Page

  • 107 - 113

PubMed ID

  • 32234201

Pubmed Central ID

  • 32234201

Electronic International Standard Serial Number (EISSN)

  • 2162-5239

Language

  • eng

Conference Location

  • United States