Background Polytrauma patients are at a higher risk of delayed gastric emptying. To assess the gastric volume, a reliable diagnostic tool is needed to prevent the occurrence of aspiration pneumonia, which remains a serious complication associated with anesthesia. Gastric antral ultrasound can provide reliable information about the size of the gastric antrum in traumatized patients undergoing emergency surgery. Methods A prospective observational study of 45 polytrauma patients undergoing emergency surgery under general anesthesia was carried out. Prior to induction of anesthesia in the emergency department, gastric ultrasound was performed for qualitative and quantitative assessment of the gastric antrum in a supine position and right lateral decubitus (RLD) position. This was followed by routine placement of the nasogastric tube to aspirate and calculate the volume of the stomach contents. Results Of the 45 polytrauma patients, the risk assessment of aspiration and the anesthesia technique changed in 14 patients (31.1%) after the gastric ultrasound examination. A very good relationship existed between the expected stomach volume at the RLD position and the suction volume in the nasogastric tube. In all cases, no aspirations were documented. Conclusion Ultrasound examination of the stomach in polytrauma patients allows assessing the size and type of stomach contents. The data obtained can influence the choice of anesthesia technique and reduce the risk of aspiration pneumonia. Trial registration This trial was registered at ClinicalTrials.gov. registry number: NCT04083677 on September 6, 2019.

Background Patients with reduced ejection fraction (EF) undergoing CABG are more likely to develop postoperative morbidity and mortality. It is controversial about which cardioplegia solution, temperature, and method of administration ensure optimal cardiac muscle preservation during CABG surgery. Aim of the study The aim of the study was to compare intermittent antegrade warm blood cardioplegia with cold crystalloid cardioplegia during CABG in patients with low EF (30–40%). Methods Patients (n = 100) undergoing elective isolated on-pump CABG were prospectively randomized into group I (n = 50) which received antegrade cold crystalloid cardioplegia and group II (n = 50) which received antegrade warm blood cardioplegia. Blood samples were collected immediately and 12 and 24 h postoperatively. CK-MB and cardiac troponin I were measured and compared between the two groups. Other indicators such as use of inotropic support and use of intra-aortic balloon counter pulsation (IABC) were also documented. Results Preoperative demographic and clinical variables were matched in both groups. However, postoperative CK-MB and troponin I were higher in group I compared to group II. There was less need for inotropic support and IABC with better postoperative course in group II than in group I. Conclusion There was a significant reduction in the release of cardiac enzymes and less need for inotropic support with better postoperative outcome in patients who received antegrade warm blood cardioplegia versus cold crystalloid cardioplegia.

Background: Polytrauma patients are at a higher risk of delayed gastric emptying. To assess gastric volume, a reliable diagnostic tool is needed to prevent the occurrence of aspiration pneumonia, which remains a serious complication associated with anesthesia. Gastric antral ultrasound can provide reliable information about the size of the gastric antrum in traumatized patients undergoing emergency surgery.Methods: A prospective observational study of 45 polytrauma patients undergoing emergency surgery under general anesthesia. Prior to induction of anesthesia in the emergency department, gastric ultrasound was performed to allow qualitative and quantitative assessment of gastric antrum in a supine position and right lateral decubitus (RLD) position. Followed by routine placement of nasogastric tube to aspirate and calculate the volume of the stomach contents.Results: Forty-five polytrauma patients who underwent gastric ultrasound examination showed that the risk assessment of aspiration and anesthesia technique changed in 14 patients (31.1%) after the ultrasound examination.A very good relationship existed between the expected stomach volume at the RLD position and the suction volume in the nasogastric tube. In all cases, no aspirations were documented.Conclusion: Ultrasound examination of the stomach in polytrauma patients allows assessing the size and type of stomach contents. The data obtained can influence the choice of anesthesia technique while inducing anesthesia and reduce the risk of aspiration pneumonia.Trial registration: This trial was registered at ClinicalTrials.gov. Registry number: NCT04083677.

This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12871-022-01759-6.