Ultrasonographic assessment of preoperative gastric volume in patients with dyspepsia: a prospective observational study
Yuming Tan, Xianchun Wang, Han Yang, Chuanlong Pan, Nanbo Luo, Junjie Li, Fang Yang, Yanling Bei, Zhen Cahilog, Qian Chen, Zhiheng Liu, Xinping Yang
Abstract
BACKGROUND: Patients undergoing gastroenteroscopy during sedation are prone to aspiration, and most patients with dyspepsia have delayed gastric emptying. This study aimed to investigate the feasibility of measuring the gastric antrum cross-sectional area (CSA) to supply a novel clinical diagnostic reference value in patients with dyspepsia. METHODS: Patients with dyspepsia undergoing elective gastroscopy were included. The Perlas qualitative 0-2 grading scale score was determined before the operation. The anteroposterior diameter (D1) and craniocaudal diameter (D2) between gastric antrum serosal surfaces were measured perpendicular to each other in the supine and right lateral decubitus (RLD) positions. CSA values in the supine position and RLD position were determined. Gastric contents were endoscopically suctioned with the volumes measured and noted as actual gastric volume. Multiple regression analysis was used to fit a mathematical model for estimating the gastric volume. Receiver operating characteristic (ROC) curves were constructed to determine the accuracy of RLD CSA to detect gastric volumes of > 0.8 ml/kg. RESULTS: , respectively. Two new modified mathematical models were derived to predict an estimated gastric volume for FD and organic dyspepsia: volume = 3.93 × RLD CSA - 0.47 × age; and volume = 6.15 × RLD CSA - 0.61 × age. CONCLUSION: We used the cut-off value of the antral area for the fast diagnosis of gastric volumes in patients with dyspepsia, which may assist clinicians in identifying patients at risk of aspiration. TRIAL REGISTRATION: www.chictr.org.cn ( CHICTR-DDD-17010871 ); registered 15 March 2017.