Brazilian journal of anesthesiology (Elsevier) · 2018
[Comparative ultrasound study of gastric emptying between an isotonic solution and a nutritional supplement].
Сравнительное исследованиеСтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Bisinotto Flora Margarida Barra, Silveira Luciano Alves Matias da, Rossi Tiago Caneu, Martins Laura Bisinotto, Zago Gustavo Palis, Mendonça Mariana Andrade Lopes
Аннотация
BACKGROUND AND OBJECTIVES: Preoperative fasting may lead to undesirable effects in the surgical patient in whom there is a stimulus to ingesting clear liquids until 2 hours before anesthesia. The aim of this study was to evaluate the gastric emptying of two different solutions using ultrasound.
METHODS: In a prospective, randomized, blind study, 34 healthy volunteers ingested 200 mL of two solutions without residues in two steps: an isotonic solution with carbohydrates, electrolytes, osmolarity of 292 mOsm.L−1, and 36 kcal; and other nutritional supplementation with carbohydrates, proteins, electrolytes, osmolarity of 680 mO.L−1, and 300 kcal. After 2 hours, a gastric ultrasound was performed to assess the antrum area and gastric volume, and the relation of gastric volume to weight (vol.w−1), whose value above 1.5 mL.kg−1 was considered a risk for bronchoaspiration. A p-value <0.05 was considered statistically significant.
RESULTS: There was a significant difference between all parameters evaluated 2 hours after the ingestion of nutritional supplementation compared to fasting. The same occurred when the parameters between isotonic solution and nutritional supplementation were compared 2 hours after ingestion. Only one patient had vol.w−1 <1.5 mL.kg−1 2 hours after ingestion of nutritional supplementation; and only one had vol.w−1 >1.5 mL.kg−1 after ingestion of isotonic solution.
CONCLUSION: This study demonstrated that gastric emptying of equal volumes of different solutions depends on their constitution. Those with high caloric and high osmolarity, and with proteins present, 2 hours after ingestion, increased the gastric volumes, which is compatible with the risk of gastric aspiration.
METHODS: In a prospective, randomized, blind study, 34 healthy volunteers ingested 200 mL of two solutions without residues in two steps: an isotonic solution with carbohydrates, electrolytes, osmolarity of 292 mOsm.L−1, and 36 kcal; and other nutritional supplementation with carbohydrates, proteins, electrolytes, osmolarity of 680 mO.L−1, and 300 kcal. After 2 hours, a gastric ultrasound was performed to assess the antrum area and gastric volume, and the relation of gastric volume to weight (vol.w−1), whose value above 1.5 mL.kg−1 was considered a risk for bronchoaspiration. A p-value <0.05 was considered statistically significant.
RESULTS: There was a significant difference between all parameters evaluated 2 hours after the ingestion of nutritional supplementation compared to fasting. The same occurred when the parameters between isotonic solution and nutritional supplementation were compared 2 hours after ingestion. Only one patient had vol.w−1 <1.5 mL.kg−1 2 hours after ingestion of nutritional supplementation; and only one had vol.w−1 >1.5 mL.kg−1 after ingestion of isotonic solution.
CONCLUSION: This study demonstrated that gastric emptying of equal volumes of different solutions depends on their constitution. Those with high caloric and high osmolarity, and with proteins present, 2 hours after ingestion, increased the gastric volumes, which is compatible with the risk of gastric aspiration.