METHODS: This was a single-center, prospective, observational study on adult ICU subjects who were enterally fed for at least 6 h continuously and mechanically ventilated. Gastric ultrasound was performed immediately prior to commencement of fasting, after 4 h of fasting, and after nasogastric (NG) aspiration after 4 h of fasting. An empty stomach was defined as a gastric volume ≤ 1.5 mL/kg.
RESULTS: Forty subjects were recruited, and 38 (95%) had images suitable for analysis. The prevalence of empty stomach increased after 4 h of fasting (25 [65.8%] vs 31 [81.6%], P = .041) and after 4 h of fasting with NG aspiration (25 [65.8%] vs 34 [89.5%], P = .008). There was a significant difference in median (interquartile range) gastric volume per body weight between before fasting and 4 h after fasting (1.0 [0.5-1.8] mL/kg vs 0.4 [0.2-1.0] mL/kg, P < .001). No patient factors were associated with higher prevalence of empty stomach after 4 h of fasting.
CONCLUSIONS: Most mechanically ventilated subjects had empty stomachs prior to fasting for extubation. Fasting for 4 h further increased the prevalence of empty stomach at extubation to > 80%.
方法:这是一个单中心,prospective,观察性研究的成人ICU受试者连续肠内喂养至少6小时并进行机械通气。在开始禁食之前立即进行胃超声检查,禁食4小时后,和禁食4小时后的鼻胃(NG)抽吸后。空腹定义为胃体积≤1.5mL/kg。
结果:招募了40名受试者,和38(95%)的图像适合分析。空腹4小时后空腹患病率增加(25[65.8%]vs31[81.6%],P=.041),并在禁食4小时后进行NG抽吸(25[65.8%]vs34[89.5%],P=.008)。禁食前和禁食后4小时之间的中位(四分位数范围)胃体积/体重存在显着差异(1.0[0.5-1.8]mL/kgvs0.4[0.2-1.0]mL/kg,P<.001)。禁食4小时后,没有患者因素与空腹患病率较高相关。
结论:大多数机械通气的受试者在禁食拔管前胃排空。禁食4小时后,拔管时空腹的患病率进一步增加至>80%。