Routine Point of Care Ultrasound (POCUS) Assessment of Antral Gastric Contents in Traumatic Surgical Patients for Prevention of Aspiration Pneumonitis

NCT04083677 | Unknown

• 1 other identifier: Ain Shams university 11
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Pulmonary aspiration of gastric contents is uncommon in the elective, surgical populations, but highly prevalent in trauma patients who requires emergency surgery as trauma impair gastric motility and emptying.1 Presence of residual gastric volume at the time of anesthetic induction is an important risk of aspiration pneumonitis.2 Routine use of non-invasive bedside ultrasound gives information about the volume and nature of gastric volume. Determination of gastric content volume preoperatively will help the anesthetist in the assessment of pulmonary aspiration risk 3, 4 Ultrasongraphic measurment of antral CSA (cross sectional area) can diagnose risk stomach during the preoperative period defined by a gastric volume at risk of pulmonary aspiration (ie presence of Solid particles and/or gastric volume \>1.5 ml/kg)5 The aim of our study is to allow routine use of point of care ultrasound (pocus) of gastric contents in order to inform an assessment of aspiration risk and guide anesthetic mangment

Conditions

Aspiration

Outcome Measures

Primary Outcomes (1)

• gastric content

  gastric content volume by sonar

  6 months

Study Arms (2)

Control GROUP

healthy adult fasting 8 hours before the operation sonographic examination of gastric antrum before anesthesia

Device: SONAR

trauma GROUP

trauma patients fasting 8 hours before the operation sonographic examination of gastric antrum before anesthesia

Device: SONAR

Interventions

SONAR DEVICE

A curved low- frequency (2-5 MHZ) probe and (simens ACUSON x 300) ultrasound system will be used. All patient will be first scanned in the supine position, followed by the right lateral decubitus (RLD) position. The gastric antrum was identified in a sagittal scanning plane in the epigastrium immediately inferior to xiphoid and superior to umbilicus. The liver anteriorly and the aorta, inferior vena cava and pancreas posteriorly were used as anatomical reference points.

Control GROUP; trauma GROUP

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

The study included forty five polytrauma patients (18-65 years old of both sexes) admitted for emergency surgery.

You may qualify if:

• polytrauma patients admitted for emergency surgery.

You may not qualify if:

• patients with obesity (BMI\> 35kg/m2),
• pregnancy,
• a history of upper gastrointestinal diseases including gastroesophageal reflux disease, hiatus hernia, gastroeosphgeal cancer or upper GIT surgery.

Sponsors & Collaborators

• Ain Shams University: lead

Study Sites (1)

Ramymahrose

Cairo, 02, Egypt

Location

Related Publications (1)

• Shorbagy MS, Kasem AA, Gamal Eldin AA, Mahrose R. Routine point-of-care ultrasound (POCUS) assessment of gastric antral content in traumatic emergency surgical patients for prevention of aspiration pneumonitis: an observational clinical trial. BMC Anesthesiol. 2021 May 8;21(1):140. doi: 10.1186/s12871-021-01357-y.

  PMID: 33964867 DERIVED

Study Officials

• ramy mahrose, md

  asuh

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: lecturer of anesthesia at faculty of medicine ain shams university

Study Record Dates

• First Submitted: September 6, 2019
• First Posted: September 10, 2019
• Study Start: September 1, 2019
• Primary Completion: October 1, 2019
• Study Completion: November 30, 2019
• Last Updated: November 25, 2019

Record last verified: 2019-11

Locations

EG (1)