Prevalence of Children at High Risk for Pulmonary Aspiration Assessed by Gastric Ultrasonography in Elective Surgical Patients

Authors

  • Sutthirak Kuruhongsa, M.D. กลุ่มงานวิสัญญีวิทยา สถาบันสุขภาพเด็กแห่งชาติมหาราชินี
  • Patitha Chullabodhi, M.D. Queen Sirikit National Institute of Child Health
  • Duenpen Horatanaruang, M.D. Queen Sirikit National Institute of Child Health
  • Natthapong Lepananon, M.D. Queen Sirikit National Institute of Child Health
  • Trisana Soontrakom, M.D. Queen Sirikit National Institute of Child Health
  • Kannika Maokwang, B.N.S. Queen Sirikit National Institute of Child Health

Keywords:

gastric ultrasonography, gastric volume, gastric content, pediatric anesthesia, pulmonary aspiration

Abstract

Background: Although pulmonary aspiration is rare, it is a serious anesthetic complication that can lead to significant morbidity and mortality. One of the important associated factors is the residual gastric content volume. Using the ultrasonography, the equipment generally used in anesthetic practice, to examine the gastric content and volume before anesthesia can help identify the high-risk patients. Therefore, this method can be one modality to prevent pulmonary aspiration and increase patient safety.Objective: To study the prevalence of pediatric patients at high risk for pulmonary aspiration assessed by gastric ultrasonography in elective surgical patients receiving standard preoperative fasting.Methods: 256 elective surgical pediatric patients, ASA physical status I-II, 1-15 years old were enrolled into this cross-sectional descriptive study. Preoperative gastric ultrasonography was performed in supine and right lateral decubitus position. The gastric content was evaluated and classified into 0-2 qualitative grading scale. The gastric volume per kilogram was also calculated by formula using antral cross-sectional area, the cut-off points for increasing aspiration risk were gastric volume more than 1.25 ml/kg or solid gastric content. The results were immediately reported to attending anesthesiologist before induction. Age, sex, BMI, fasting time, ASA status, grading scale and gastric volume were recorded and analyzed using descriptive statistics.Results: The prevalence of high-risk patient was 6.6%. Median fasting time of clear liquid and food or milk were 10 and 10.5 hours respectively. The median gastric volume was 0.7 ml/kg. None of the patients had solid gastric content or developed pulmonary aspiration.Conclusion: The prevalence of children at high risk for pulmonary aspiration was 6.6% in healthy elective surgical pediatric patients receiving standard preoperative care. The gastric ultrasonography was simple, convenient and feasible in the practice of anesthesia.

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Author Biography

Patitha Chullabodhi, M.D., Queen Sirikit National Institute of Child Health

Queen Sirikit National Institute of Child Health

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Published

21-01-2022

How to Cite

1.
Kuruhongsa ส, Chullabodhi ป, Horatanaruang เ, Lepananon ณ, Soontrakom ต, Maokwang ก. Prevalence of Children at High Risk for Pulmonary Aspiration Assessed by Gastric Ultrasonography in Elective Surgical Patients. j dept med ser [Internet]. 2022 Jan. 21 [cited 2022 Aug. 18];46(4):91-9. Available from: https://he02.tci-thaijo.org/index.php/JDMS/article/view/250664

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Original Article