Abstract：
Interpretation of gastric ultrasound relies on the use of a clinical algorithm that combines qualitative analysis of the gastric antrum contents with the calculation of the volume of fluid contents. This reference method may be difficult to apply in the parturient. We therefore aimed to assess the diagnostic accuracy of a simple qualitative assessment in the supine position for the diagnosis of high-risk gastric contents in the parturient. We also assessed the diagnostic accuracy of a composite scale and another clinical algorithm based on a mathematical model different to that used in the reference method.
Prospective observational cohort study.
University hospital, Lyon, France.
Adult women admitted to the delivery room.
Qualitative and quantitative gastric ultrasound examination within the first hour following admission.
With respect to the reference method, the diagnostic accuracy of a simple qualitative assessment for the diagnosis of high-risk gastric contents was assessed. The diagnostic accuracy of a composite scale and another clinical algorithm, and the agreement between each approach were also assessed.
A total of 235 parturients were included and analyzed. The simple qualitative assessment led to conclusive ultrasound assessment in 233 (99%) women, while the reference method led to conclusive assessment in 213 (91%) women (P < 0.05). The sensitivity and the specificity of the simple qualitative assessment were 97% (95%CI: 93 to 99%) and 96% (95%CI: 90 to 99%), respectively. These were not significantly different from those of the composite scale and the clinical algorithm. The four approaches showed almost perfect agreement with each other.
These results suggest that simple qualitative assessment may be useful in clinical practice to help the anesthesiologist in the assessment of gastric contents status and risk of aspiration.
Prospective observational cohort study.
University hospital, Lyon, France.
Adult women admitted to the delivery room.
Qualitative and quantitative gastric ultrasound examination within the first hour following admission.
With respect to the reference method, the diagnostic accuracy of a simple qualitative assessment for the diagnosis of high-risk gastric contents was assessed. The diagnostic accuracy of a composite scale and another clinical algorithm, and the agreement between each approach were also assessed.
A total of 235 parturients were included and analyzed. The simple qualitative assessment led to conclusive ultrasound assessment in 233 (99%) women, while the reference method led to conclusive assessment in 213 (91%) women (P < 0.05). The sensitivity and the specificity of the simple qualitative assessment were 97% (95%CI: 93 to 99%) and 96% (95%CI: 90 to 99%), respectively. These were not significantly different from those of the composite scale and the clinical algorithm. The four approaches showed almost perfect agreement with each other.
These results suggest that simple qualitative assessment may be useful in clinical practice to help the anesthesiologist in the assessment of gastric contents status and risk of aspiration.
摘要：
目的：胃超声的解释依赖于临床算法的使用，该算法将胃窦内容物的定性分析与液体内容物的体积计算相结合。这种参考方法可能难以在产妇中应用。因此，我们旨在评估仰卧位简单定性评估的诊断准确性，以诊断产妇的高危胃内容物。我们还基于与参考方法中使用的数学模型不同的数学模型，评估了复合量表和另一种临床算法的诊断准确性。
方法：前瞻性观察性队列研究。
方法：大学医院，里昂,法国。
方法：成年女性进入产房。
方法：入院后第一小时内进行定性和定量胃超声检查。
方法：关于参考方法，评估了简单定性评估对高危胃内容物诊断的诊断准确性.复合量表和另一种临床算法的诊断准确性，并评估了每种方法之间的协议。
结果：共纳入235例产妇并进行分析。简单的定性评估导致233（99％）女性的超声评估，而参考方法对213名(91%)女性进行了结论性评估(P<0.05)。简单定性评估的敏感性和特异性分别为97％（95CI：93至99％）和96％（95CI：90至99％），分别。这些与复合量表和临床算法没有显着差异。这四种方法显示出几乎完美的一致性。
结论：这些结果表明，简单的定性评估可能有助于在临床实践中帮助麻醉师评估胃内容物状态和误吸风险。
方法：前瞻性观察性队列研究。
方法：大学医院，里昂,法国。
方法：成年女性进入产房。
方法：入院后第一小时内进行定性和定量胃超声检查。
方法：关于参考方法，评估了简单定性评估对高危胃内容物诊断的诊断准确性.复合量表和另一种临床算法的诊断准确性，并评估了每种方法之间的协议。
结果：共纳入235例产妇并进行分析。简单的定性评估导致233（99％）女性的超声评估，而参考方法对213名(91%)女性进行了结论性评估(P<0.05)。简单定性评估的敏感性和特异性分别为97％（95CI：93至99％）和96％（95CI：90至99％），分别。这些与复合量表和临床算法没有显着差异。这四种方法显示出几乎完美的一致性。
结论：这些结果表明，简单的定性评估可能有助于在临床实践中帮助麻醉师评估胃内容物状态和误吸风险。
