title: Ultrasonographic gastric antral area and gastric contents volume in children.
abstract: BACKGROUND
  Cross-sectional gastric antral area (GAA) measurements by ultrasonography (US) have been proposed for preoperative assessment of gastric volume in adults but not been validated in children. This study investigates whether in children gastric volumes can be predicted by US performed in different patient positions.
  
  
  METHODS
  Gastric fluid and air volumes were examined by magnetic resonance imaging before or up to 120 min after ingestion of 7 ml·kg(-1) diluted raspberry syrup in healthy volunteers who had fasted overnight. GAA was measured with US three times each in supine (SUP), elevated 45° degree supine (E45) and right decubital (RDC) position using imaging planes defined by vascular landmarks. Correlation coefficients (Pearson) between GAA and gastric volumes were calculated and Bland-Altman analysis performed.
  
  
  RESULTS
  Sixteen children aged from 6.4 to 12.8 (9.2) years were included in 23 examinations: 6 after overnight fasting, 3 directly after, and 14 with a delay of 74 ± 35 min after fluid intake. GAA was 221 ± 116, 218 ± 112, and 347 ± 188 mm(2) for SUP, E45, and RDC position, respectively. The best correlation between body weight corrected total gastric/gastric fluid volume (TGV(w)/GFV(w)) with GAA was found for RDC position (R = 0.79; P < 0.01/R = 0.78; P < 0.01). Bias and precision of calculated and measured GFV(w) was 0 ± 2.8 ml·kg(-1).
  
  
  CONCLUSIONS
  Correlations between GAA and TGV(w) or GFV(w) in children are best in the RDC position, but not sufficient to predict GFV(w) with a given GAA. Interpretation of isolated GAA values may be misleading.
authors: Department of Anaesthesia, University Children's Hospital, Zurich, Switzerland. achim.schmitz@kispi.uzh.ch
authors: Achim
authors: A
authors: Schmitz
authors: Schraner
authors: S
authors: Thomas
authors: Fruehauf
authors: F
authors: Melanie
authors: Liamlahi
authors: L
authors: Rabia
authors: Richard
authors: R
authors: Klaghofer
authors: Markus
authors: M
authors: Weiss
authors: Christian
authors: C
authors: Kellenberger
mesh_terms: D000375:Aging / Q000502:physiology; D019412:Anatomy, Cross-Sectional; D002648:Child; D005260:Female; D005746:Gastric Emptying; D005766:Gastrointestinal Contents; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011187:Posture / Q000502:physiology; D011706:Pyloric Antrum / Q000000981:diagnostic imaging*; D012044:Regression Analysis; D013270:Stomach / Q000033:anatomy & histology; D016683:Supine Position / Q000502:physiology; D014463:Ultrasonography