Ultrasound Assessment of Gastric Contents and Volume in Paediatric Surgical Patients: A Clinical Audit
DOI:
https://doi.org/10.4103/kaj/2024/v19i1-4/173197Keywords:
Elective Paediatric Surgical Patients, Gastric Ultrasound, Paediatric Anaesthesia, Pulmonary AspirationAbstract
Background: Perioperative pulmonary aspiration of gastric contents is a rare event in the clinical practice of paediatric anaesthesia. The volume of the gastric content is one of the predisposing factors for pulmonary aspiration. The present clinical audit aimed to detect “at-risk stomach” by ultrasound visualisation of solid gastric contents and/or by quantification of gastric volume>1.25mL/kg body weight in children scheduled for elective surgery. Materials and Methods: Children aged 1 to 18 years scheduled for elective surgery were subjected to preoperative gastric ultrasound examination in supine and right lateral decubitus positions after obtaining parental consent. Gastric contents were qualitatively graded and the gastric volume was quantified by a previously validated formula. Statistical analysis was done using Microsoft Excel (2013). Results: Fifty-one children were scheduled for elective surgery during the one month of the audit. In five children antrum could not be visualised due to excessive air and hence were excluded and 46 children were included for data analysis. None of the children had solid gastric contents. The mean calculated gastric volume was16.6±13.8 mL and the mean gastric volume/kg was 0.68±0.4 mL/kg. Three children had gastric volume >1.25mL/kg signifying “at-risk stomach”. Three children had Grade 2 stomach as assessed qualitatively. Conclusion: Ultrasound assessment of gastric contents and residual volume is a good preoperative tool in the paediatric population to detect children at risk of pulmonary aspiration of gastric contents.
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