title: Qualitative and quantitative ultrasound assessment of gastric content.
abstract: Pulmonary aspiration of the gastric contents is one of the most feared complications in anesthesia. Its prevention depends on preoperative fasting as well as identification of risky patients. A reliable diagnostic tool to assess gastric volume is currently lacking. The aim of this study performed on volunteers was to evaluate the feasibility of ultrasonography to identify qualitative and quantitative gastric content.
  A standardized gastric scanning protocol was applied on 67 healthy volunteers to assess the gastric antrum in four different situations: fasting, after ingesting clear fluid, milk and a solid meal. A qualitative and quantitative assessment of the gastric content in the antrum was performed by a blinded sonographer. The antrum was considered either as empty, or containing clear or thick fluid, or solids. Total gastric volume was predicted based on a cross-sectional area of the antrum. A p-value less than 0.05 was considered statistically significant.
  For each type of gastric content, the sonographic characteristics of the antrum and its content were described and illustrated. Sonographic qualitative assessment allowed to distinguish between an empty stomach and one with different kinds of meal. The predicted gastric volume was significantly larger after the consumption of any food source compared to fasting.
  Bedside sonography can determine the nature of gastric content. It is also possible to estimate the difference between an empty gastric antrum and one that has some food in it. Such information may be useful to estimate the risk of aspiration, particularly in situations when prandial status is unknown or uncertain.
authors.affiliation: MD, Anesthesiologist. PhD in Anesthesiology. Adjunct Professor, Department of Surgery, Universidade Federal do Triângulo Mineiro (UFTM), Uberaba, MG, Brazil.
authors.forename: Flora Margarida Barra
authors.initials: FM
authors.lastname: Bisinotto
authors.affiliation: MD, Anesthesiologist. Medical Residency in Anesthesiology at the Teaching and Training Center (CET)/Sociedade Brasileira de Anestesiologia (SBA), Hospital de Clínicas da UFTM, Uberaba, MG, Brazil.
authors.forename: Patrícia Luísa
authors.initials: PL
authors.lastname: Pansani
authors.affiliation: MD, Anesthesiologist. Auxiliary Professor, Department of Surgey, UFTM, Uberaba, MG, Brazil.
authors.forename: Luciano Alves Matias da
authors.initials: LA
authors.lastname: Silveira
authors.affiliation: MD, Radiologist, Hospital de Clínicas da UFTM, Uberaba, MG, Brazil.
authors.forename: Aline de Araújo
authors.initials: AA
authors.lastname: Naves
authors.affiliation: MD, Radiologist, Hospital de Clínicas da UFTM, Uberaba, MG, Brazil.
authors.forename: Ana Cristina Abdu
authors.initials: AC
authors.lastname: Peixoto
authors.affiliation: Medical Student at UFMT, Scientific Initiation Grant from UFTM (BIC/Fapemig), Uberaba, MG, Brazil.
authors.forename: Hellen Moreira de
authors.initials: HM
authors.lastname: Lima
authors.affiliation: Medical Student at Universidade de Ribeirão Preto, Scientific Initiation Grant from UFTM, Ribeirão Preto, SP, Brazil.
authors.forename: Laura Bisinotto
authors.initials: LB
authors.lastname: Martins
mesh_terms: D000328:Adult; D000758:Anesthesia / Q000009:adverse effects; D003430:Cross-Sectional Studies; D005215:Fasting; D005240:Feasibility Studies; D005260:Female; D005766:Gastrointestinal Contents / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011015:Pneumonia, Aspiration / Q000209:etiology / Q000517:prevention & control; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D011706:Pyloric Antrum / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D055815:Young Adult