Gastric point-of-care ultrasound evaluation in pediatric emergency department procedural sedation patients; is the stomach empty at the point of scheduled revisit?

Abstract

Objectives: This study aimed to use gastric point of care ultrasound (POCUS) to estimate the prevalence of an “empty stomach” among patients undergoing procedural sedation and analgesia (PSA) in the emergency department (ED) after observing the requisite fasting time at home. Methods: A prospective observational study was conducted with children with facial lacerations who made a scheduled revisit to the ED after completion of the recommended fasting time. Their stomach contents were assessed with a sagittal view of the gastric antrum by POCUS in the right lateral decubitus position. The characteristics of gastric contents were described as empty, solid, and liquid with an estimated gastric volume. “Empty stomach” was defined as a collapsed gastric antrum or calculated a gastric fluid volume of less than or equal to 1.25 mL/kg on POCUS. Results: Gastric POCUS was performed in 125 patients, and the final analysis included 122 patients. For 95 patients who had followed the recommended fasting time, the median fasting time was 7 hours for solids and 6 hours for liquids, and 78 (82%) patients had an empty stomach. Conversely, seven of 27 patients (26%) who did not have an adequate fasting time had an empty stomach. The optimal cut-off value of fasting time to predict an empty stomach was 6.5 hours based on a receiver operating characteristic (ROC) analysis (sensitivity = 0.767, specificity = 0.811). Conclusions: Most scheduled revisiting children had an “empty stomach” at the time of sedation after the recommended fasting. However, providers should be aware that one in five children still had stomach residue, although they had more than 6 hours of fasting.

Ultrassonografia na prática assistencial do enfermeiro do bloco operatório: revisão de escopo

“…South Korea 2021 (9) Signa Vitae Observational Assessment of gastric contents before pediatric emergency surgeries.…”

“…The volume definition to be considered RU changes the incidence that the results will point to at the end of the research. Finally, several authors recommend systematically evaluating patients undergoing anesthetic recovery using USG, based on well-designed protocols that guide routine in recovery units, considering the risk to patients (9,10,12,14) .…”

DKC1 aggravates gastric cancer cell migration and invasion through up-regulating the expression of TNFAIP6

“…At present, the detection rate of early GC in China is low. Lymph node metastasis or even distant organ metastasis has been found in most GC patients at first diagnosis, which could not be cured through surgery and affected the prognosis and survival rate of patients (Karimi et al 2014 ; Tan 2019 ; Na et al 2021 ). Despite the continuous development of endoscopic technology and the remarkable progress of immunotherapy, the current GC therapeutic effect is restricted, so the death rate of GC in China keeps high (Zong et al 2016 ; Zhang and Yu 2020 ; Sezik et al 2021 ; Sun et al 2021 ).…”