| Objective: To explore the feasibility of the antral cross-sectional area(ACSA)measurement in assessing gastric volume using the bedside ultrasound,and to provide a reference for evaluation of risks of aspiration in critically ill patients,so that guiding the development of reasonable enteral nutrition program for critically ill patients.Methods:Critically ill patients admitted to the intensive care unit(ICU)from Oct.2015 to Dec.2016 at the Yi Ji Shan hospital and Nan Ling Hospital were collected as the critically ill group.(1)To study the value of monitoring gastric residues with ultrasound.Fifteen critically ill patients were enrolled in this study.After received enteral nutrition for 6 hours,the ACSA of the patients were detected by the ultrasound as semirecumbent position,and the relationship of the amount of withdrawal enteral nutrition and ACSA was examined using the means of withdrawing the gastric contents.(2)To study the consistency of gastric volume and antral area assessed by ultrasound.19 surgical patients from orthopedics and gynecology received ultrasonic examination as semi-recumbent position,after get fasting for at least 8 hours,followed by nasal feeding200 ml warm water.The results related to the ACSA as fasting state and filling state were compared.The cut-off value corresponding to an increased gastric content was determined by ultrasound measurement of antral CSA.The gastric motility GV1 and GV2 were calculated by formula Bouvet and formula Perlas based on antrum area assessed before,then choosing formula which is suitable for Chinese in evaluating gastric volume by ultrasound monitoring.Results:(1)there was a positive correlation relationship between the ACSA and gastric volume,By conducting Pearson correlation analysis and detection of related factors such as withdrawing amount,age,height,weight,ACSA,body surface area and so on,it found that the intragastric withdrawing amount had positive correlation relationship with the antrum cross section area(r=0.907,P=0.000)and the value after being adjusted was R2=0.809.Regression analysis was carried out by assuming the intragastric withdrawing amount being Y and the antrum cross section area being X,the regression equation was obtained as follows: Y=26.019X-108.825.The verifying of regression equation showed the equation is effective(F=60.374,P=0.000)and statistically significant.(2)The measured clinical data were substituted respectively into the present studied computational formula 1 and computational formula 2 by reference to calculate the gastric residual volume and got GV1 and GV2.When matching T test was conducted with P > 0.05,and there were no statistical differences between the two formulas.But the dispersion degree of formula 2 was increased obviously than that of GV1,and GV1 was more suitable for the forecast calculation of ultrasonic gastric retention amount for Chinese.Conclusions:(1)It is feasible to evaluate gastric volume using bedside ultrasound measure the ACSA.The ACSA and gastric volume has a positive correlation relationship.(2)The cut-off value of the ACSA is 1075mm~2 for liquid.The Bouvet formula combined with ACSA could be used in predicting gastric residual in Chinese,which is beneficial for implementation of enteral nutrition in critically ill patients. |
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