Ultrasound dynamics of gastric content volumes after the ingestion of coconut water or a meat sandwich. A randomized controlled crossover study in healthy volunteers

Carmona, Bruno Mendes; Almeida, Clauber Claudino Alves; Vieira, Waldonio de Brito; Fascio, Mário de Nazareth Chaves; Carvalho, Lídia Raquel de; Vane, Luiz Antonio; Barbosa, Fabiano Timbó; Nascimento, Paulo do; Módolo, Norma Sueli Pinheiro

doi:10.1016/j.bjane.2018.06.004

Cited by 3 publications

(3 citation statements)

References 40 publications

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“…This indicates that for patients with delayed gastric emptying, an 8-h fasting time may not be sufficient. It has been shown that the general diet empties more slowly than liquid or semi-fluid foods [ 40 ], and we found that the gastric fluid volume still differed between patients with different diets after fasting up to 8h. This is correlated with the patient’s actual gastrointestinal preparation, who are usually told to eat a liquid or semi-liquid diet the night before.…”

Section: Discussionmentioning

confidence: 63%

A convenient machine learning model to predict full stomach and evaluate the safety and comfort improvements of preoperative oral carbohydrate in patients undergoing elective painless gastrointestinal endoscopy

Jin,

Ma,

Yan

et al. 2023

Annals of Medicine

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Background and aims Assessment of the patient’s gastric contents is the key to avoiding aspiration incidents, however, there is no effective method to determine whether elective painless gastrointestinal endoscopy (GIE) patients have a full stomach or an empty stomach. And previous studies have shown that preoperative oral carbohydrates (POCs) can improve the discomfort induced by fasting, but there are different perspectives on their safety. This study aimed to develop a convenient, accurate machine learning (ML) model to predict full stomach. And based on the model outcomes, evaluate the safety and comfort improvements of POCs in empty- and full stomach groups. Methods We enrolled 1386 painless GIE patients between October 2022 and January 2023 in Nanjing First Hospital, and 1090 patients without POCs were used to construct five different ML models to identify full stomach. The metrics of discrimination and calibration validated the robustness of the models. For the best-performance model, we further interpreted it through SHapley Additive exPlanations (SHAP) and constructed a web calculator to facilitate clinical use. We evaluated the safety and comfort improvements of POCs by propensity score matching (PSM) in the two groups, respectively. Results Random Forest (RF) model showed the greatest discrimination with the area under the receiver operating characteristic curve (AUROC) 0.837 [95% confidence interval (CI): 79.1–88.2], F1 71.5%, and best calibration with a Brier score of 15.2%. The web calculator can be visited at https://medication.shinyapps.io/RF_model/ . PSM results demonstrated that POCs significantly reduced the full stomach incident in empty stomach group ( p < 0.05), but no differences in full stomach group ( p > 0.05). Comfort improved in both groups and was more significant in empty stomach group. Conclusions The developed convenient RF model predicted full stomach with high accuracy and interpretability. POCs were safe and comfortably improved in both groups, with more benefit in empty stomach group. These findings may guide the patients’ gastrointestinal preparation.

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Section: Discussionmentioning

confidence: 63%

A convenient machine learning model to predict full stomach and evaluate the safety and comfort improvements of preoperative oral carbohydrate in patients undergoing elective painless gastrointestinal endoscopy

Jin,

Ma,

Yan

et al. 2023

Annals of Medicine

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“…Carmona et al carried out a prospective study involving 17 healthy volunteers who had ingested a standard 145 g, 355 kcal meat sandwich. They reported that the mean gastric emptying time was 4.5 ± 0.9 h [18]. Using real-time gastric sonography, Bolondi et al described that the gastric emptying time in general populations was 4.1 ± 0.7 h after the ingestion of a standard 800 kcal Italian meal containing pasta with tomato sauce, meat with vegetables, bread, and water [12].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Gastric Emptying Time of a Rice-Based Meal Using Serial Sonography

Cho

Kim

Byeong

et al. 2019

BioMed Research International

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The aim of this prospective study was to evaluate the gastric emptying time of a rice-based meal by serial ultrasonography of the stomach. After baseline ultrasonographic assessment of ten fasted healthy volunteers, volunteers ingested standardized 420 g, 536 kcal rice-based meal (bibimbap), and serial evaluations were performed every hour until the stomach became empty. At baseline, all the participants had an empty stomach. The average time of complete gastric emptying of the rice-based meal was 5.8 ± 0.8 h (95% confidence interval (CI), 5.0 h to 6.5 h). Since the first postintake cross-sectional area (CSA) measurement, a decrease was observed, and CSA was maintained until postprandial 3–4 h (P > 0.05). It declined rapidly 4 h after meal intake (P=0.031), reaching the nadir at approximately 6 h after meal intake. The gastric CSA and hunger score showed a positive correlation (correlation r = 0.616, P < 0). The rice-based meal is emptied after 5.8 ± 0.8 h on average in healthy volunteers. Based on our results, 6.5 h (upper limit of CI) of fasting after the ingestion of a rice-based meal would be a safe preoperative fasting time, and this is in accordance with the current guidelines for preoperative fasting.

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“…The evaluation of the type of gastric content was described in 11 articles, analyzed by differentiating between solid, liquid, and empty stomach contents. 1,[7][8][9][10][11]16,[18][19][20][21] The imaging findings according to gastric content were as follows:…”

Section: Qualitative Evaluationmentioning

confidence: 99%

Ultrasonographic evaluation of gastric content and volume: a systematic review

Kamada

NETO

et al. 2020

Rev. Assoc. Med. Bras.

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SUMMARY OBJECTIVE: Bronchoaspiration of gastric content is associated with high morbidity and mortality, but evaluating this complication is a difficult task. However, gastric ultrasonography can safely assess gastric content and prevent bronchoaspiration. Therefore, a systematic review was performed in order to verify the efficacy of ultrasonography in the qualitative and quantitative analyses of gastric content. METHODS: A literature review of articles published between 2009 and 2019 in the PubMed and LILACS databases was conducted using combinations of the keywords “gastric ultrasound,” “gastric emptying,” and “gastric content.” RESULTS: Of the 20 articles found, 19 chose the antral region as the best site for qualitative analysis of the gastric content. Regarding quantitative measurement, the most commonly used method to calculate the gastric volume in eight articles was the formula “Gastric Volume = 27 + (14.6 × ATAG) − (1.28 × Age),” in which the area of the transverse section of the gastric antrum (ATAG) could also be calculated by the largest antral diameters or by free tracing. CONCLUSION: An efficient evaluation of the gastric content can be performed by ultrasonography of the antral region, contributing to greater safety in the clinical management of patients with increased risk for bronchoaspiration during airway management.

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Ultrasound dynamics of gastric content volumes after the ingestion of coconut water or a meat sandwich. A randomized controlled crossover study in healthy volunteers

Cited by 3 publications

References 40 publications

A convenient machine learning model to predict full stomach and evaluate the safety and comfort improvements of preoperative oral carbohydrate in patients undergoing elective painless gastrointestinal endoscopy

A convenient machine learning model to predict full stomach and evaluate the safety and comfort improvements of preoperative oral carbohydrate in patients undergoing elective painless gastrointestinal endoscopy

Evaluation of Gastric Emptying Time of a Rice-Based Meal Using Serial Sonography

Ultrasonographic evaluation of gastric content and volume: a systematic review

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