When fasted is not empty: A retrospective cohort study of gastric content in fasted surgical patients

British Journal of Anaesthesia

Volumn 118, Issue 3, 2017, Pages 363-371

  Van De Putte, P ^a   Vernieuwe, L ^b   Jerjir, A ^c   Verschueren, L ^b   Tacken, M ^d   Perlas, A ^e  

^a AZ Monica   (Belgium)

^b ANTWERP UNIVERSITY HOSPITAL   (Belgium)

^c UNIVERSITY HOSPITALS LEUVEN   (Belgium)

^d RADBOUD UNIVERSITY MEDICAL CENTER   (Netherlands)

^e TORONTO WESTERN HOSPITAL   (Canada)

Author keywords

Fasted; Gastric contents; Gastric ultrasound

Indexed keywords

ACID ASPIRATION; ADULT; AGED; ARTICLE; COHORT ANALYSIS; COMORBIDITY; DIET RESTRICTION; ELECTIVE SURGERY; FEMALE; HUMAN; INCIDENCE; MAJOR CLINICAL STUDY; MALE; OUTCOME ASSESSMENT; PRIORITY JOURNAL; REAL TIME ULTRASOUND SCANNER; RETROSPECTIVE STUDY; RISK FACTOR; STOMACH CONTENT; STOMACH EMPTYING; SURGICAL PATIENT; ULTRASOUND; ULTRASOUND TRANSDUCER; DIAGNOSTIC IMAGING; ECHOGRAPHY; MIDDLE AGED; POINT OF CARE SYSTEM; PROCEDURES; STOMACH; STOMACH JUICE;

ADULT; COHORT STUDIES; ELECTIVE SURGICAL PROCEDURES; FASTING; FEMALE; GASTROINTESTINAL CONTENTS; HUMANS; MALE; MIDDLE AGED; POINT-OF-CARE SYSTEMS; RETROSPECTIVE STUDIES; STOMACH; ULTRASONOGRAPHY;

EID: 85016078249     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aew435     Document Type: Article

References (42)

1. Mendelson CL. The aspiration of stomach contents into the lungs during obstetric anaesthesia. Am J Obstet Gynecol 1946; 52: 191-205
2. Cook TM, Woodall N, Frerk C. On behalf of the Royal College of Anaesthetists. Report and findings of the 4th National Report and findings of the 4th National Audit Project of the Royal College of Anaesthetists. March 2011; ISBN 978-1-9000936-03-3
3. Engelhardt T, Webster NR. Pulmonary aspiration of gastric contents in anaesthesia. Br J Anaesth 1999; 83: 453-60
4. Levy DM. Pre-operative fasting-60 years on from Mendelson. Continuing Educ Anaesth Crit Care Pain 2006; 6: 215-8
5. American Society of Anaesthesiologists. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures. Anesthesiology 2011; 114: 495-511
6. Van de Putte P, Perlas A. Ultrasound assessment of gastric content and volume. Br J Anaesth 2014; 113: 12-22
7. Sakai T, Planinsic RM, Quinlan JJ, Handley LJ, Kim TY, Hilmi IA. The incidence and outcome of perioperative pulmonary aspiration in a university hospital: a 4-year retrospective analysis. Anesth Analg 2006; 103: 941-7
8. Perlas A, Chan VW, Lupu CM, Mitsakakis N, Hanbidge A. Ultrasound assessment of gastric content and volume. Anesthesiology 2009; 111: 82-9
9. Bouvet L, Miquel A, Chassard D, Boselli E, Allaouiche B, Benhamou D. Could a single standardized ultrasound measurement of antral area be of interest for assessing gastric contents? A preliminary report. Eur J Anesthesiol 2009; 26: 1015-9
10. Perlas A, Davis L, Khan M, Mitsakakis N, Chan VW. Gastric sonography in the fasted surgical patient: a prospective descriptive study. Anesth Analg 2011; 113: 93-7
11. Cubillos J, Tse C, Chan VW, Perlas A. Bedside ultrasound assessment of gastric content: an observational study. Can J Anaesth 2012; 59: 416-23
12. Bouvet L, Mazoit JX, Chassard D, Allaouchiche B, Boselli E, Benhamou D. Clinical assessment of the ultrasonographic measurement of antral area for estimating preoperative gastric content and volume. Anesthesiology 2011; 114: 1086-92
13. Perlas A, Mitsakakis N, Liu L, et al. Validation of a mathematical model for ultrasound assessment of gastric volume by gastroscopic examination. Anesth Analg 2013; 116: 357-63
14. Kruisselbrink R, Arzola C, Endersby R, Tse C, Chan V, Perlas A. Intra-and interrater reliability of ultrasound assessment of gastric volume. Anesthesiology 2014; 121: 46-51
15. McCallum RW, Berkowitz DM, Lerner E. Gastric emptying in patients with gastroesophageal reflux. Gastroenterology 1981; 80: 285-91
16. Vaezi MF, Richter JE. Role of acid and duodenogastroesophageal reflux in gastroesophageal reflux disease. Gastroenterology 1996; 111: 1192-9
17. Gonlachanvit S, Maurer AH, Fisher RS, Parkman HP. Regional gastric emptying abnormalities in functional dyspepsia and gastro-oesophageal reflux disease. Neurogastroenterol Motil 2006; 18: 894-904
18. Pellegrini C, Antonioli L, Colucci R, et al. Gastric motor dysfunctions in Parkinson's disease: current pre-clinical evidence. Parkinsonism Relat Disord 2015; 21: 1407-14
19. Lamboeuf Y, Fritsch P, de Saint-Blanquat G. Gastric emptying and intestinal transit after treatment with disulfiram in the rat. Biol Gastroenterol (Paris) 1975; 8: 39-44
20. Amine El M, Kaoutar S, Ihssane M, Adil I, Dafr-Allah B. Effect of Ramadan fasting on acute upper gastrointestinal bleeding. J Res Med Sci 2013; 18: 230-3
21. Hutchinson A, Maltby JR, Reid CR. Gastric fluid volume and pH in elective inpatients. Part I: coffee or orange juice versus overnight fast. Can J Anaesth 1988; 35: 12-5
22. Agarwal A, Chari P, Singh H. Fluid deprivation before operation: the effect of a small drink. Anesthesia 1989; 44: 632-4
23. Read MS, Vaughan RS. Allowing pre-operative patients to drink: effects on patients' safety and comfort of unlimited oral water until 2 hours before anaesthesia. Acta Anaesthesiol Scand 1991; 35: 591-5
24. Maltby JR, Lewis P, Martin A, Sutheriand LR. Gastric fluid volume and pH in elective patients following unrestricted oral fluid until three hours before surgery. Can J Anaesth 1991; 38: 425-9
25. Hausel J, Nygren J, Lagerkranser M, et al. A carbohydrate-rich drink reduces preoperative discomfort in elective surgery patients. Anesth Analg 2001; 93: 1344-50
26. Van de Putte P, Perlas A. Gastric sonography in the severely obese surgical patient: a feasibility study. Anesth Analg 2014; 119: 1105-10
27. Roberts RB, Shirley MA. Reducing the risk of acid aspiration during cesarean section. Anesth Analg 1974; 53: 859-68
28. Raidoo DM, Rocke DA, Brock-Utne JG,Marszalek A, Engelbrecht HE. Critical volume for pulmonary acid aspiration: reappraisal in a primate model. Br J Anaesth 1990; 65: 248-50
29. Schreiner MS. Gastric fluid volume: is it really a risk factor for pulmonary aspiration? Anesth Analg 1998; 87: 754-6
30. Samsom M, Vermeijden JR, Smout AJ, et al. Prevalence of delayed gastric emptying in diabetic patients and relationship to dyspeptic symptoms: a prospective study in unselected diabetic patients. Diabetes Care 2003; 26: 3116-22
31. Shen HL, Yang SP, Hong LW, et al. Evaluation of gastric emptying in diabetic gastropathy by an ultrasonic whole stomach cylinder method. Ultrasound Med Biol 2014; 40: 1998-2003
32. McCallum RW, Soykan I, Sridhar KR, Ricci DA, Lange RC, Plankey MW. Delta-9-tetrahydrocannabinol delays the gastric emptying of solid food in humans: a double-blind, randomized study. Aliment Pharmacol Ther 1999; 13: 77-80
33. Esfandyari T, Camilleri M, Ferber I, Burton D, Baxter K, Zinsmeister AR. Effect of a cannabinoid agonist on gastrointestinal transit and postprandial satiation in healthy human subjects: a randomized, placebo-controlled study. Neurogastroenterol Motil 2006; 18: 831-8
34. Benhamou D. Ultrasound assessment of gastric contents in the perioperative period: why is this not part of our daily practice? Br J Anaesth 2015; 114: 545-8
35. Alakkad H, Kruisselbrink R, Chin KJ, et al. Point-of-care ultrasound defines gastric content and changes the anesthetic management of elective surgical patients who have not followed fasting instructions: a prospective case series. Can J Anaesth 2015; 62: 1188-95
36. Franke A, Nakchbandi IA, Schneider A, Harder H, Singer MV. The effect of ethanol and alcoholic beverages on gastric emptying of solid meals in humans. Alcohol Alcohol 2005; 40: 187-93
37. Bagyanszki M, Krecsmarik M, De Winter BY, et al. Chronic alcohol consumption affects gastrointestinal motility and reduces the proportion of neuronal NOS-immunoreactive myenteric neurons in the murine jejunum. Anat Rec (Hoboken) 2010; 293: 1536-42
38. Grimes DS, Goddard J. Effect of cigarette smoking on gastric emptying. Br Med J 1978; 2: 460-1
39. Sanaka M, Anjiki H, Tsutsumi H, et al. Effect of cigarette smoking on gastric emptying of solids in Japanese smokers: a crossover study using the 13C-octanoic acid breath test. J Gastroenterol 2005; 40: 578-82
40. Laffey JG, Carroll M, Donnelly N, Boylan JF. Instructions for ambulatory surgery-patient comprehension and compliance. Ir J Med Sci 1998; 167: 160-3
41. Walker H, Thorn C, Omundsen M. Patients' understanding of pre-operative fasting. Anaesth Intensive Care 2006; 34: 358-61
42. Cantellow S, Lightfoot J, Bould H, Beringer R. Parents' understanding of and compliance with fasting instruction for pediatric day case surgery. Paediatr Anaesth 2012; 22: 897-900