PDF(Pubmed)
Abstract：
UNASSIGNED: Airway management for nonelective surgical procedures in the setting of trauma, pain, and opioid use can be complicated by the potential for aspiration due to delayed gastric emptying. Point-of-care ultrasound (POCUS) remains a useful tool for evaluating gastric content and volume in various clinical settings. The authors evaluated gastric volume and content in children scheduled for urgent and semi-urgent procedures to assess their aspiration risk.
UNASSIGNED: After obtaining consent, gastric POCUS was performed in the preoperative holding area for pediatric patients scheduled for both elective and nonelective surgery. Qualitative and quantitative measurements of the gastric antrum were taken, and the risk of gastric aspiration was calculated. Additional data collected included patient demographics, the type of surgery, nil per os (NPO) status at the time of surgery, NPO status at the time of injury, and administration of opioids.
UNASSIGNED: The study cohort included 100 patients ranging in age from 3 to 17 years old (mean age 9.2 years). Out of these 100 patients, gastric scanning was successfully conducted in 98 patients. Sixteen of fifty-nine nonelective patients (27%) had received opioids for pain control prior to surgery. Among the 34 patients who had suffered an acute injury, 7 (21%) had been NPO for <8 hours at the time of the injury. Ninety-nine out of hundred patients had been NPO for at least 6 hours at the time of the gastric ultrasound. Based on our gastric ultrasound findings, all patients who were appropriately NPO had either Grade 0 or Grade 1 risk for aspiration, indicating a low risk of aspiration.
UNASSIGNED: The preliminary data show that when patients presenting for nonelective surgery are appropriately NPO, they may have a low risk of aspiration. This information may help guide the choice of anesthetic induction technique, particularly when concerns exist about the safety of a rapid sequence induction. It allows for a more stable and controlled induction of anesthesia.
UNASSIGNED: After obtaining consent, gastric POCUS was performed in the preoperative holding area for pediatric patients scheduled for both elective and nonelective surgery. Qualitative and quantitative measurements of the gastric antrum were taken, and the risk of gastric aspiration was calculated. Additional data collected included patient demographics, the type of surgery, nil per os (NPO) status at the time of surgery, NPO status at the time of injury, and administration of opioids.
UNASSIGNED: The study cohort included 100 patients ranging in age from 3 to 17 years old (mean age 9.2 years). Out of these 100 patients, gastric scanning was successfully conducted in 98 patients. Sixteen of fifty-nine nonelective patients (27%) had received opioids for pain control prior to surgery. Among the 34 patients who had suffered an acute injury, 7 (21%) had been NPO for <8 hours at the time of the injury. Ninety-nine out of hundred patients had been NPO for at least 6 hours at the time of the gastric ultrasound. Based on our gastric ultrasound findings, all patients who were appropriately NPO had either Grade 0 or Grade 1 risk for aspiration, indicating a low risk of aspiration.
UNASSIGNED: The preliminary data show that when patients presenting for nonelective surgery are appropriately NPO, they may have a low risk of aspiration. This information may help guide the choice of anesthetic induction technique, particularly when concerns exist about the safety of a rapid sequence induction. It allows for a more stable and controlled induction of anesthesia.
摘要：
■创伤情况下非选择性外科手术的气道管理，疼痛,和阿片类药物的使用可能会由于胃排空延迟而导致误吸。护理点超声（POCUS）仍然是在各种临床环境中评估胃内容物和体积的有用工具。作者评估了计划进行紧急和半紧急手术的儿童的胃体积和内容物，以评估其吸入风险。
■获得同意后，对于计划进行择期和非择期手术的儿科患者,在术前保留区进行胃POCUS.对胃窦进行定性和定量测量，并计算胃误吸的风险。收集的其他数据包括患者人口统计，手术的类型,手术时无操作系统(NPO)状态，受伤时的非营利组织状态，和阿片类药物的管理。
■该研究队列包括100名患者，年龄在3至17岁之间（平均年龄9.2岁）。在这100名患者中，98例患者成功进行了胃扫描。59名非选择性患者中有16名（27％）在手术前接受了阿片类药物来控制疼痛。在遭受急性损伤的34名患者中，7（21％）在受伤时已NPO<8小时。在胃超声检查时，一百名患者中有九十九名已经NPO至少6小时。根据我们的胃超声检查结果,所有符合NPO标准的患者均有0级或1级误吸风险,表明误吸的风险较低。
■初步数据表明，当接受非选择性手术的患者是适当的NPO时，他们的误吸风险可能很低。这些信息可能有助于指导麻醉诱导技术的选择，特别是当存在对快速序列诱导的安全性的担忧时。它允许更稳定和受控的麻醉诱导。
■获得同意后，对于计划进行择期和非择期手术的儿科患者,在术前保留区进行胃POCUS.对胃窦进行定性和定量测量，并计算胃误吸的风险。收集的其他数据包括患者人口统计，手术的类型,手术时无操作系统(NPO)状态，受伤时的非营利组织状态，和阿片类药物的管理。
■该研究队列包括100名患者，年龄在3至17岁之间（平均年龄9.2岁）。在这100名患者中，98例患者成功进行了胃扫描。59名非选择性患者中有16名（27％）在手术前接受了阿片类药物来控制疼痛。在遭受急性损伤的34名患者中，7（21％）在受伤时已NPO<8小时。在胃超声检查时，一百名患者中有九十九名已经NPO至少6小时。根据我们的胃超声检查结果,所有符合NPO标准的患者均有0级或1级误吸风险,表明误吸的风险较低。
■初步数据表明，当接受非选择性手术的患者是适当的NPO时，他们的误吸风险可能很低。这些信息可能有助于指导麻醉诱导技术的选择，特别是当存在对快速序列诱导的安全性的担忧时。它允许更稳定和受控的麻醉诱导。
