Diagnostic performance of qualitative ultrasound assessment for the interpretation of point-of-care gastric ultrasound to detect high gastric fluid volume: A prospective randomized crossover study

Bouvet, Lionel; Cordoval, Julien; Barnoud, Sophie; Berlier, Jean; Desgranges, François-Pierrick; Chassard, D.

doi:10.1016/j.jclinane.2022.110919

Cited by 5 publications

(24 citation statements)

References 21 publications

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“…We performed a supplementary analysis of a prospective randomized observer‐blind crossover trial that had received institutional ethics committee approval ( Comité de Protection des Personnes Sud‐Ouest et Outre‐Mer II , N° 2019‐A01333‐54, Chairperson Professor Bettina Couderc, Toulouse, France) and had been registered in the public registry http://clinicaltrials.gov No. NCT04097236 8 . The study was conducted between November 27, 2019 and September 6, 2021.…”

Section: Methodsmentioning

confidence: 99%

“…Healthy adult volunteers were included in the study; inclusion criteria were: American Society of Anesthesiologists physical status 1, age ≥ 18 years, fasting duration for clear fluids ≥2 h, and that of solids ≥6 h. Volunteers with history of gastrointestinal surgery, digestive disease, gastroparesis, insulin‐dependent diabetes mellitus, volunteers with obesity (body mass index ≥30 kg.m −2 ), those taking medications affecting gastric motility, and pregnant or breastfeeding women, were not included 8 …”

Section: Methodsmentioning

confidence: 99%

“…The sample size had been calculated to show that qualitative ultrasound assessment in the semirecumbent position allowed the detection of gastric fluid volume >1.5 mL.kg −1 with a sensitivity ≥90% 22,23 . The inclusion of 20 volunteers, in whom three ultrasound assessments were made in each position, had been planned 8 . It was predetermined that if a volunteer withdrew prematurely from the study or if ultrasound evaluation of the gastric contents was inconclusive, the data collected would be excluded from the analysis.…”

Section: Methodsmentioning

confidence: 99%

“…It is nevertheless considered that a gastric fluid volume >1.5 mL.kg −1 corresponds to high gastric fluid volume that may favor the occurrence of aspiration by itself 5–7 . We therefore recently assessed the ability of gastric ultrasound to detect gastric fluid volume >1.5 mL.kg −1 , 8 and found that the ultrasound visualization of clear fluids in volunteers lying down in the supine position with the head of the bed at 45° allowed the diagnosis of gastric fluid volume >1.5 mL.kg −1 with a sensitivity of 91% and a positive predictive value of 71% 8 . The diagnostic accuracy of this simple qualitative assessment was not significantly different from that of a composite ultrasound scale nor from that of a clinical algorithm including calculation of gastric fluid volume 8 …”

Section: Introductionmentioning

confidence: 99%

“…The aim of this supplementary analysis of a previously published trial was to determine the diagnostic accuracy of a simple qualitative ultrasound examination in the semirecumbent position for the diagnosis of empty stomach defined as gastric fluid volume <0.8 mL.kg −1 8,15,16 . The diagnostic accuracy of qualitative assessment performed without head‐of‐bed elevation and of a composite ultrasound scale and clinical algorithm with or without head‐of‐bed elevation for the diagnosis of empty stomach, was also assessed 16–19 …”

Section: Introductionmentioning

confidence: 99%

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Diagnostic accuracy of a simple qualitative ultrasound assessment for the diagnosis of empty stomach in the adult: A supplementary analysis of a prospective observer‐blind randomized crossover study

Bouvet

Desgranges

Barnoud

et al. 2023

Acta Anaesthesiol Scand

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BackgroundIt has been reported that qualitative ultrasound assessment performed in the semi‐upright position had high sensitivity to detect gastric fluid volume >1.5 mL.kg−1. Nevertheless, the diagnostic accuracy of qualitative assessment for the diagnosis of empty stomach (fluid volume <0.8 mL.kg−1) has not been assessed. We aimed to assess the diagnostic accuracy of simple qualitative ultrasound assessment with and without head‐of‐bed elevation to 45° for the diagnosis of an empty stomach. We also aimed to determine the diagnostic accuracy of a composite ultrasound scale and clinical algorithm.MethodsWe performed a supplementary analysis of a prospective observer‐blind randomized crossover trial in which adult fasting volunteers attended two distinct sessions, with the head‐of‐bed angled either at 0° or 45°, in a randomized order. Three tests were performed within each session, each corresponding to a different (either 0, 50, 100, 150 or 200 mL) and randomized volume of water; the same volumes were ingested in both sessions, in a randomized order. Ultrasounds were performed 3 min after water ingestion, blindly to the volume ingested.ResultsWe included 20 volunteers in whom 120 measurements were analyzed. The sensitivity and specificity of the qualitative assessment in the semirecumbent position were 93% (95% CI: 68–100) and 89% (95% CI: 76–96), respectively. The composite scale and clinical algorithm did not have better diagnostic accuracy than the qualitative assessment performed with head‐of‐bed elevation. Without head‐of‐bed elevation, the clinical algorithm had significantly higher specificity (98% [95% CI: 88–100]) than qualitative assessment (67% [95% CI: 51–80]; p < 0.05).ConclusionThese results suggest that qualitative assessment in the semirecumbent position had high diagnostic accuracy for the diagnosis of fluid volume <0.8 mL.kg−1; this method can be used in clinical practice for reliable diagnosis of empty stomach.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%