Consistency of Sonographic Estimations of Gastric Residual Volume Among Non Radiologists with Limited Examination Period.

Abstract

Background: Pulmonary aspiration is a constant risk in patients planned for anesthesia and those who are critically ill. Ultrasonic examination of the stomach gives a valuable assessment opportunity to predict gastric residual volume. Involvement of non-radiologists for its estimation can potentially prevent lots of incidences of aspiration and consequently pulmonary complications and even deaths. Both the duration required for the training and the examination period for estimation, are still to be studied.Objectives: This study tries to illustrate the consistency of measurements of gastric antral area among three anesthesia trainees as novice sonographic readers with a short training course and to measure the applicability of lowering the examination time to two minutes in both semi sitting (Fowler`s) position and right lateral recumbent position.Design: Prospective study at a tertiary teaching hospital. Patients included are in intensive care unit with a nasogastric feeding tube. Three anesthesia trainees with equal training courses in the subject were recruited and have their sonographic evaluation compared in two patients positions. They all are blinded to time, type, and volume of last enteral intake.Results: The readings reported by the three doctors in either lateral or supine positiondid not show significant statistical differences (P value >0.05). Consistency of thereadings among the three doctors was high (Cronbach’s alpha = 0.926).Conclusion: Anesthesiologists with short term appropriately performed courses canuncover the risk of gastric contents regurgitation and aspiration with only a two minute bedside gastric sonographic examination.

Keywords

• pulmonary aspiration
• gastric ultrasound
• point of care ultrasound
• gastric residual volume.