Assessment of Volume and Residuals in Stomach Using High-Frequency Ultrasound Waves in Non-Emergency Surgical Patients with Chronic Kidney Disease
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Abstract
Introduction: Pulmonary aspiration during perioperative period has severe complications, especially in chronic kidney disease (CKD) patients who have more risk due to delayed gastric emptying time. This study aims to evaluate gastric contents and volume using ultrasound, assess the prevalence of pulmonary aspiration in high-risk CKD patients undergoing elective surgery, and identify associated risk factors. Methods: This prospective descriptive study involved assessing 90 CKD patients scheduled for elective surgery. Gastric contents and volume were examined using ultrasound in both supine and right lateral decubitus positions. High risk for pulmonary aspiration was defined by the presence of solid contents or excessive fluid equal to or exceeding 1.5 ml/kg in the right lateral decubitus position. Results: Nineteen patients (21.1%) exhibited a full stomach, with 6 patients in CKD stage III (31.6%), 7 in CKD stage IV (36.8%), and 6 in CKD stage V (31.6%). Solid contents were identified in all patients, and diabetes emerged as a significant risk factor (odds ratio: 7.84, 95% CI 1.65-37.21). No incidents of pulmonary aspiration occurred during anesthesia. Conclusion: Despite adhering to standard fasting protocols, CKD patients remain susceptible to pulmonary aspiration. Pre-surgery gastric assessment using ultrasound effectively identified conditions of a full stomach, facilitating the planning of appropriate and safe anesthesia.
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