CJEM · 2026
Clinical applications of gastric point-of-care ultrasound in adult emergency and critical care: a scoping review.
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Razzaq Saad, Todorova Zlatitsa, Hamoudeh Rami, Turenne Malick, Martin Emily R, Datta Aurgho, Chandra Astha, Turner Joel
Аннотация
BACKGROUND AND OBJECTIVES: Point-of-care ultrasound (PoCUS) is a cornerstone of bedside assessment in emergency and critical care, providing rapid, radiation-free visualization of anatomy and pathology. Gastric PoCUS offers a non-invasive method to assess gastric content, volume, and motility, informing management of aspiration risk, airway interventions, and enteral feeding. Despite supporting evidence, its use remains limited and poorly standardized. The objective of this scoping review is to map the clinical applications of gastric PoCUS in adult emergency department (ED) and intensive care unit (ICU) patients.
METHODS: A scoping review was conducted according to PRISMA-ScR guidelines. Medline, Embase, Scopus, Cochrane, CINAHL, were searched from 1950 to May 2025 for studies evaluating gastric ultrasound in adult ED or ICU populations. Two reviewers independently screened, extracted, and charted data.
RESULTS: Thirty-five studies met inclusion criteria. Clinical applications of gastric PoCUS among ED and ICU were clustered under three domains: aspiration risk assessment and airway management (n = 5); enteral nutrition and gastric residual volume monitoring (n = 12); and diagnostic evaluation or therapeutic monitoring (n = 18). Across studies, gastric PoCUS reliably differentiated gastric content types, estimated gastric volume, and informed airway and feeding decisions. In diagnostic contexts, gastric PoCUS enabled rapid bedside identification of gastric outlet obstruction, volvulus, intramural hematoma, and perforated viscus. No studies reported complications or harm caused by performing gastric PoCUS.
CONCLUSIONS: Gastric PoCUS is a versatile bedside tool bridging diagnostic and therapeutic domains in emergency and critical care. It enhances patient safety, optimizes nutritional management, and reduces radiographic dependence. Standardization of scanning protocols, structured training, and multicenter outcome-based validation studies are needed to support routine integration in acute care.
METHODS: A scoping review was conducted according to PRISMA-ScR guidelines. Medline, Embase, Scopus, Cochrane, CINAHL, were searched from 1950 to May 2025 for studies evaluating gastric ultrasound in adult ED or ICU populations. Two reviewers independently screened, extracted, and charted data.
RESULTS: Thirty-five studies met inclusion criteria. Clinical applications of gastric PoCUS among ED and ICU were clustered under three domains: aspiration risk assessment and airway management (n = 5); enteral nutrition and gastric residual volume monitoring (n = 12); and diagnostic evaluation or therapeutic monitoring (n = 18). Across studies, gastric PoCUS reliably differentiated gastric content types, estimated gastric volume, and informed airway and feeding decisions. In diagnostic contexts, gastric PoCUS enabled rapid bedside identification of gastric outlet obstruction, volvulus, intramural hematoma, and perforated viscus. No studies reported complications or harm caused by performing gastric PoCUS.
CONCLUSIONS: Gastric PoCUS is a versatile bedside tool bridging diagnostic and therapeutic domains in emergency and critical care. It enhances patient safety, optimizes nutritional management, and reduces radiographic dependence. Standardization of scanning protocols, structured training, and multicenter outcome-based validation studies are needed to support routine integration in acute care.