Gastric Ultrasound for Airway Management in Emergency Patients

NCT07640165 | Completed

• 1 other identifier: GastricUSG
• Study Type: observational
• Target: 43
• Locations: 1 country
• Sites: 1

Brief Summary

This prospective observational cohort study evaluates the association between gastric residual content and volume, assessed by point-of-care gastric ultrasound (PoCUS), and the choice of airway management technique (Rapid Sequence Intubation vs. non Rapid Sequence Intubation) in adult emergency surgical patients at Rumah Sakit Cipto Mangunkusumo (RSCM). Aspiration risk in emergency patients is a critical concern, and this study examines whether objective ultrasonographic findings change clinical decision-making compared to traditional clinical assessment alone.

Conditions

Pulmonary Aspiration of Gastric Contents; Emergency Surgery; Gastric Residual Volume; Airway Management

Keywords

airway management; rapid sequence induction (RSI); gastric ultrasound; aspiration risk; emergency; point-of-care ultrasound (PoCUS)

Outcome Measures

Primary Outcomes (1)

• Association between aspiration risk based on gastric ultrasound findings and airway management technique selection

  Proportion of patients in whom airway management technique (Rapid Sequence Intubation vs. non Rapid Sequence Intubation) was associated with aspiration risk category (high vs. low) determined by preoperative gastric Point-of-Care Ultrasound (PoCUS) findings. Aspiration risk classified as high if Gastric Residual Volume (GRV) ≥1.5 ml/kg or solid gastric content; low if GRV \<1.5 ml/kg or empty stomach. Analyzed using chi-square test.

  At time of pre-induction assessment (single time point, intraoperative)

Secondary Outcomes (8)

• Change in Airway Management Plan After Gastric USG

  Before and immediately after gastric USG, prior to anesthetic induction

• Gastric Residual Volume

  At pre-induction assessment

• Gastric Content Type

  At pre-induction assessment

• Fasting Duration and Its Relationship to Gastric Residual Volume

  At pre-induction assessment

• American Society of Anesthesiologists (ASA) Physical Status Classification as a factor in airway management decision

  At pre-induction assessment

Study Arms (1)

Emergency Surgical Patients

Adult emergency surgical patients (age \>18 years) requiring airway management at the Emergency Operating Room of RSUPN Dr. Cipto Mangunkusumo (RSCM), who underwent preoperative gastric point-of-care ultrasound (PoCUS) to assess gastric content type and residual volume prior to anesthetic induction.

Device: Preoperative Gastric Point-of-Care Ultrasound (PoCUS)

Interventions

Preoperative Gastric Point-of-Care Ultrasound (PoCUS) DEVICE

Gastric antrum ultrasound performed using a low-frequency transducer (2-5 MHz; SonoSite M-Turbo or Lumify Philips) in the supine position before anesthetic induction. The antrum cross-sectional area (CSA) was measured during the relaxation phase between two peristaltic contractions, calculating cranio-caudal (CC) and antero-posterior (AP) diameters. Gastric residual volume (GRV) was calculated using the Perlas formula: GV = 27.0 + 14.6 × CSA - 1.28 × age (years). Gastric content was classified as empty, liquid, solid, or mixed. Aspiration risk was categorized as high (GRV ≥1.5 ml/kg or solid content) or low (GRV \<1.5 ml/kg or empty).

Also known as: Gastric USG, Gastric Ultrasound, Bedside Gastric Sonography

Emergency Surgical Patients

Eligibility Criteria

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

Study Population

Adult emergency surgical patients (age \>18 years) requiring airway management under general anesthesia at the Emergency Operating Room of RSUPN Dr. Cipto Mangunkusumo (RSCM), Jakarta, Indonesia. The population includes both trauma (62.8%) and non-trauma (37.2%) emergency cases. Patients were enrolled consecutively from July to August 2025. Patients with conditions that could confound gastric ultrasound assessment or airway management decisions were excluded.

You may qualify if:

• Emergency patients requiring airway management in the Emergency Operating Room
• Age \>18 years

You may not qualify if:

• Pregnancy
• Morbid obesity (BMI \>40 kg/m²)
• History of prior gastric or esophageal surgery
• Duodenal tube in situ
• Maxillofacial trauma or anticipated difficult airway
• Inability to adequately visualize the gastric antrum on ultrasound

Sponsors & Collaborators

• Indonesia University: lead

Study Sites (1)

RSUPN Cipto Mangunkusumo

Jakarta, Jakarta Special Capital Region, 01430, Indonesia

Location

MeSH Terms

Conditions

Respiratory Aspiration of Gastric Contents; Emergencies

Condition Hierarchy (Ancestors)

Laryngopharyngeal Reflux; Gastroesophageal Reflux; Esophageal Motility Disorders; Deglutition Disorders; Esophageal Diseases; Gastrointestinal Diseases; Digestive System Diseases; Respiratory Aspiration; Respiration Disorders; Respiratory Tract Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Disease Attributes

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Anesthesiologist

Study Record Dates

• First Submitted: June 2, 2026
• First Posted: June 10, 2026
• Study Start: June 5, 2025
• Primary Completion: August 13, 2025
• Study Completion: September 13, 2025
• Last Updated: June 10, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will not share

Locations

ID (1)