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Abstract：
OBJECTIVE: Our goal was to evaluate the effect of diabetic severity and duration on preoperative residual gastric volume. Secondarily we compared ultrasonic estimates of residual gastric volume with actual volume determined by aspiration during endoscopy.
METHODS: This was a prospective, observational cohort study that included adults with a history of diabetes mellitus and/or opioid use scheduled for gastrointestinal endoscopic procedures.
METHODS: Endoscopy unit at Cleveland Clinic Main Campus from 2017 to 2019.
METHODS: Adults scheduled for upper endoscopy with or without colonoscopy.
METHODS: Residual gastric volumes were primarily determined by aspiration during endoscopy, and secondarily estimated with ultrasound. We evaluated the relationship between gastric residual volume and preoperative HBA1C concentration and duration of diabetes. Secondarily, we conducted an agreement analysis between the two gastric volume measurement techniques.
RESULTS: Among 145 enrolled patients, 131 were diabetic and 17 were chronic opioid users. Among 131 diabetic patients, the mean ± SD HbA1c was 7.2 ± 1.5% and the median (Q1, Q3) duration of diabetes was 8.5 (3, 15) years. Neither HbA1c nor duration of diabetes was associated with residual gastric volume. The adjusted mean ratio of residual gastric volume was 1.07 (98.3% CI: 0.89, 1.28; P = 0.38) for 1% increase in HbA1c concentration, and 0.84 (98.3% CI: 0.63, 1.14; P = 0.17) for each 10-year increase induration of diabetes. The median [Q1-Q3] absolute difference between gastric ultrasound measurement and endoscopic measurement was 25 [15, 65] ml.
CONCLUSIONS: In this prospective observational cohort study, neither the duration nor severity of diabetes influenced preoperative residual gastric volume. Gastric ultrasound can help identify patients who have excessive residual volumes despite overnight fasting.
METHODS: This was a prospective, observational cohort study that included adults with a history of diabetes mellitus and/or opioid use scheduled for gastrointestinal endoscopic procedures.
METHODS: Endoscopy unit at Cleveland Clinic Main Campus from 2017 to 2019.
METHODS: Adults scheduled for upper endoscopy with or without colonoscopy.
METHODS: Residual gastric volumes were primarily determined by aspiration during endoscopy, and secondarily estimated with ultrasound. We evaluated the relationship between gastric residual volume and preoperative HBA1C concentration and duration of diabetes. Secondarily, we conducted an agreement analysis between the two gastric volume measurement techniques.
RESULTS: Among 145 enrolled patients, 131 were diabetic and 17 were chronic opioid users. Among 131 diabetic patients, the mean ± SD HbA1c was 7.2 ± 1.5% and the median (Q1, Q3) duration of diabetes was 8.5 (3, 15) years. Neither HbA1c nor duration of diabetes was associated with residual gastric volume. The adjusted mean ratio of residual gastric volume was 1.07 (98.3% CI: 0.89, 1.28; P = 0.38) for 1% increase in HbA1c concentration, and 0.84 (98.3% CI: 0.63, 1.14; P = 0.17) for each 10-year increase induration of diabetes. The median [Q1-Q3] absolute difference between gastric ultrasound measurement and endoscopic measurement was 25 [15, 65] ml.
CONCLUSIONS: In this prospective observational cohort study, neither the duration nor severity of diabetes influenced preoperative residual gastric volume. Gastric ultrasound can help identify patients who have excessive residual volumes despite overnight fasting.
摘要：
目的：我们的目的是评估糖尿病严重程度和病程对术前残余胃体积的影响。其次，我们将超声估算的残余胃体积与内窥镜检查期间通过抽吸确定的实际体积进行了比较。
方法：这是一个前瞻性的，观察性队列研究,纳入有糖尿病史和/或计划在胃肠内镜手术中使用阿片类药物的成人.
方法：2017年至2019年克利夫兰诊所主校区的内窥镜检查单元。
方法：计划进行上消化道内镜检查的成年人有或没有结肠镜检查。
方法：胃残余容积主要通过内窥镜检查期间的抽吸来确定，然后用超声波进行二次估计。我们评估了胃残留量与术前HBA1C浓度和糖尿病持续时间之间的关系。其次，我们对两种胃容积测量技术进行了一致性分析.
结果：在145名患者中，131人是糖尿病患者，17人是慢性阿片类药物使用者。在131名糖尿病患者中，平均±SDHbA1c为7.2±1.5%,中位(Q1,Q3)糖尿病病程为8.5(3,15)年.HbA1c和糖尿病持续时间均与残余胃体积无关。HbA1c浓度增加1%时，残余胃体积的调整平均比率为1.07(98.3%CI:0.89,1.28;P=0.38)，和0.84（98.3%CI：0.63，1.14；P=0.17）每增加10年的糖尿病硬结。胃超声测量和内窥镜测量之间的中位数[Q1-Q3]绝对差为25[15,65]ml。
结论：在这项前瞻性观察队列研究中，糖尿病的持续时间和严重程度均不影响术前残余胃体积。胃超声可以帮助识别尽管禁食过夜但仍有过多残余体积的患者。
方法：这是一个前瞻性的，观察性队列研究,纳入有糖尿病史和/或计划在胃肠内镜手术中使用阿片类药物的成人.
方法：2017年至2019年克利夫兰诊所主校区的内窥镜检查单元。
方法：计划进行上消化道内镜检查的成年人有或没有结肠镜检查。
方法：胃残余容积主要通过内窥镜检查期间的抽吸来确定，然后用超声波进行二次估计。我们评估了胃残留量与术前HBA1C浓度和糖尿病持续时间之间的关系。其次，我们对两种胃容积测量技术进行了一致性分析.
结果：在145名患者中，131人是糖尿病患者，17人是慢性阿片类药物使用者。在131名糖尿病患者中，平均±SDHbA1c为7.2±1.5%,中位(Q1,Q3)糖尿病病程为8.5(3,15)年.HbA1c和糖尿病持续时间均与残余胃体积无关。HbA1c浓度增加1%时，残余胃体积的调整平均比率为1.07(98.3%CI:0.89,1.28;P=0.38)，和0.84（98.3%CI：0.63，1.14；P=0.17）每增加10年的糖尿病硬结。胃超声测量和内窥镜测量之间的中位数[Q1-Q3]绝对差为25[15,65]ml。
结论：在这项前瞻性观察队列研究中，糖尿病的持续时间和严重程度均不影响术前残余胃体积。胃超声可以帮助识别尽管禁食过夜但仍有过多残余体积的患者。
