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    蔡忻妤
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    Ultrasound can be used to assess gastric emptying and the risk of aspiration in the perioperative period. It is indicated for emergency procedures, unclear fasting histories, or conditions that may delay emptying like obesity, pregnancy, or neurological disorders. The stomach is scanned using a convex transducer in the supine or right lateral position. An empty antrum appears thick-walled and ovoid, while various contents like solids, liquids, or carbonated drinks have distinguishing ultrasound appearances. The cross-sectional area of contents can determine aspiration risk, with values of 1.5 mL/kg or less in adults and 1-1.2 mL/kg or less in children indicating low risk. Ultrasound

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    Ultrasound can be used to assess gastric emptying and the risk of aspiration in the perioperative period. It is indicated for emergency procedures, unclear fasting histories, or conditions that may delay emptying like obesity, pregnancy, or neurological disorders. The stomach is scanned using a convex transducer in the supine or right lateral position. An empty antrum appears thick-walled and ovoid, while various contents like solids, liquids, or carbonated drinks have distinguishing ultrasound appearances. The cross-sectional area of contents can determine aspiration risk, with values of 1.5 mL/kg or less in adults and 1-1.2 mL/kg or less in children indicating low risk. Ultrasound

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    5 views21 pages

    Aspiration

    Uploaded by

    蔡忻妤
    Ultrasound can be used to assess gastric emptying and the risk of aspiration in the perioperative period. It is indicated for emergency procedures, unclear fasting histories, or conditions that may delay emptying like obesity, pregnancy, or neurological disorders. The stomach is scanned using a convex transducer in the supine or right lateral position. An empty antrum appears thick-walled and ovoid, while various contents like solids, liquids, or carbonated drinks have distinguishing ultrasound appearances. The cross-sectional area of contents can determine aspiration risk, with values of 1.5 mL/kg or less in adults and 1-1.2 mL/kg or less in children indicating low risk. Ultrasound

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    of 21

    Review Article

    Ultrasound assessment of gastric emptying and the risk


    of aspiration of gastric contents in the perioperative period

    Presenter ： R2 蔡忻妤
    Supervisor ： VS 胡嘉麟
    Introduction
    ↑mortality unreliable
    assessment
    ↑ Aspiration risk ：
     Pregnancy
     Diabetes mellitus
    Aspiration  Obesity
     Impaired kindey / liver functions
     Parkinson’s disease
     Neuromuscular diseases
    Indication ：
     Emergency/urgent procedure
     Unreliable/unclear fasting history
     Potential delay in gastric emptying

    Limitation ：

    Gastric
    Ultrasound Post-gastric resection Hiatal hernia
    Gastric banding
    Fundoplications
    Scanning Technique

    low-frequency (2–5 MHz)


    convex transducer
    Supine Right lateral decubitus
    Depth ： about 3–5 cm
    Gastric antrum ： left hepatic
    lobe ↔retroperitoneal
    Empty Stomach
     Thick-walled
     Ovoid or egg-like
    (less commonly flat)
     Hollow or with some
    hypoechoic substance
     Empty in both supine and
    RLD →Grade 0 antrum
    Rev assoc med Bras 2017; 63(2):134-141

    Target pattern/Bull's
    Solid Contents
     Early stage of digestion
    (usually up to 1 hour
    after solid food intake)
     Air along the anterior
    stomach wall
     Ring down artifacts

    Frosted glass pattern


    Solid Contents
     later stage of digestion
    (1–2 hours after solid
    food intake)
     Distended
     Thin-walled
     Filled with
    heterogeneous
    fragmented contents
    Dairy Products
     Homogeneous
     Hyperechoic
    contents /other
    liquids with an
    admixture of solid
    particles
    Carbonated Drinks
     Anechoic fluid in
    the lumen with
    numerous
    hyperechoic
    inclusion bodies

    Starry night
    Clear Liquids
     Thin-walled
     Ovoid with an anechoic
    (dark) substance
     The size (cross sectional
    area) →proportional to
    the amount of liquid
    =>determine the risk of
    aspiration
    Gastric Volume
     Right decubitus
    position at the aorta
    Cross Section Area (CSA) level
     ≤1.5 mL /kg (adult)
    ≤1–1.2 mL/kg (children)
    → low risk of aspiration

    Rev assoc med Bras 2017; 63(2):134-141


    Gastric Volume

    https://gastricultrasound.org/
    Gastric Volume
    Gastric Volume

    https://gastricultrasound.org/
    Limitation
    CSA in the 3rd
    trimester of
    pregnancy ≤ 9.6
    cm2 → low risk

    Body mass index (BMI) > 40 Pregnancy


    Anaesthesia 2018, 73, 295–303
    Summary
    Interpretation of
    Findings

    J Can Anesth (2018) 65:437–448


    Thank You

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