Application Of Portable Ultrasound In Patients With Dyspepsia To Assess Preoperative Gastric Volume

Objective To investigate the feasibility of gastric antral cross-sectional area(CSA)measurement by ultrasonography assess gastric volume in dyspepsia,provide a rapid evaluation scheme to reduce the risk of aspiration in patients before elective gastroscopy.Methods 120 patients with dyspepsia undergoing elective gastroscopy were included in the study.The antero-posterior diameter(D1)and craniocaudal diameter(D2)of the gastric antrum were measured in supine and right lateral decubitus(RLD)position respectively,the CSA in supine and right lateral decubitus(RLD CSA)position were calculated.Perlas scores was assessed before the operation.Gastric contents were endoscopically suctioned and measured.Multiple regression analysis was used to fit a mathematical model to estimate gastric volume,the area under the receiver operating characteristic(ROC)curve was used to evaluate the predictive power of the antral cross-sectional area in diagnosis of the presence of a volume of aspirated gastric contents greater than 0.8ml/kg.Results A total of 117 patients were enrolled finally.Receiver operating characteristic analysis to evaluate the discriminatory performance of RLD CSA to detect a volume >=0.8 ml/kg rendered an AUC of 0.83(0.75–0.90),a cut-off value was 9.96 cm~2 that displayed a sensitivity of 70.83% and a specificity of83.53%.A new modified mathematical model formula predicted gastric volume estimation:Volume = 0.44 age +4.78 RLD CSA.Conclution Using ultrasonography measurement of the RLD CSA is available for discriminating the risk of pulmonary aspiration in dyspepsia,the cut-off value of the RLD CSA>9.96 cm~2 can be considered as a high possibility of aspiration.