PDF(Pubmed)
Abstract：
Background: Gastric fluid volume has been used as a surrogate marker for pulmonary aspiration risk in studies evaluating fasting protocol safety. This study measured residual gastric fluid volume in children using a protocol in which diluted oral contrast medium was administered up until one hour before anesthesia. Methods: This was a single-center prospective observational cohort trial of 70 children for elective abdominal/pelvic computed tomography (CT). Imaging was performed after diluted enteral contrast medium administration, beginning two hours before and ending at least one hour before induction. For each patient, gastric fluid volume was calculated using an image region of interest. The primary outcome measure was gastric fluid volume measured using the computed tomography image. Results: The median time from the end of contrast administration to imaging was 1.5 h (range: 1.1 to 2.2 h). Residual gastric volume, measured using CT was <0.4 mL/Kg in 33%; ≥0.4 mL/Kg in 67%; and ≥1.5 mL/Kg in 44% of patients. Residual gastric volumes measured using CT and aspiration were moderately correlated (Spearman\'s correlation coefficient = 0.41, p = 0.0003). However, the median residual gastric volume measured using CT (1.17, IQR: 0.22 to 2.38 mL/Kg) was higher than that of aspiration (0.51, IQR: 0 to 1.58 mL/Kg, p = 0.0008 on differences in paired measures). Three cases of vomiting were reported. No evidence of pulmonary aspiration was identified. Conclusions: Children who receive large quantities of clear fluid up to one hour before anesthesia can have a significant gastric residual volume.
摘要：
背景：在评估禁食方案安全性的研究中，胃液量已被用作肺吸入风险的替代指标。这项研究使用一种方案测量了儿童的残余胃液体积，在该方案中，直到麻醉前一小时才使用稀释的口服造影剂。方法：这是一项单中心前瞻性观察性队列研究，对70名儿童进行选择性腹部/盆腔计算机断层扫描（CT）。稀释的肠内对比剂给药后进行成像,在诱导前两小时开始，至少一小时结束。对于每个病人来说,使用感兴趣的图像区域计算胃液体积.主要结果测量是使用计算机断层扫描图像测量的胃液体积。结果：从造影剂给药结束到成像的中位时间为1.5h（范围：1.1至2.2h）。残余胃容量，使用CT测量的患者为33%<0.4mL/Kg;67%≥0.4mL/Kg;44%的患者≥1.5mL/Kg.使用CT和抽吸术测量的剩余胃体积是中等相关的（Spearman相关系数=0.41，p=0.0003）。然而,用CT测量的中位残余胃体积(1.17,IQR:0.22至2.38mL/Kg)高于抽吸(0.51,IQR:0至1.58mL/Kg,p=0.0008关于配对测量的差异)。报告3例呕吐。没有发现肺吸入的证据。结论：麻醉前一小时接受大量透明液体的儿童可能会有明显的胃残留量。
