Ultrasound assessment of gastric volumes of thick fluids: Validating a prediction model

BACKGROUND Enteral nutrition is essential in the treatment of critically ill patients. Current methods to monitor enteral nutrition such as aspiration of residual volume may be inaccurate. Gastric ultrasonography estimates total gastric fluid volume using the Perlas model, but this model is validated for clear fluids only, and its accuracy for measuring thick fluids is unknown. OBJECTIVES The primary aim of this study was to evaluate the Perlas model for gastric volume estimation of enteral nutrition, a thick fluid product. DESIGN A single-centre, single blinded, randomised controlled study. SETTING Single university hospital, from May to July 2019. PARTICIPANTS Seventy-two healthy fasted volunteers were randomly allocated to different fluid volume groups. INTERVENTION Participants randomly ingested predetermined volumes between 50 and 400 ml of a feeding-drink (Nutricia Nutridrink). Following a standardised gastric ultrasound scanning protocol, a blinded sonographer measured the antral cross-sectional area in the supine and right-lateral decubitus positions. MAIN OUTCOME MEASURES Measurements were performed at baseline, 5 min postingestion and 20 min postingestion. Gastric volumes were predicted using the previously established Perlas model and compared with total gastric fluid volumes after ingestion of the study drink. RESULTS The Perlas model underestimated the volume of thick gastric fluid and yielded a suboptima...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Perioperative medicine and pain Source Type: research

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