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Journal Article
Determining residual gastric volume in healthy children using ultrasound
2023
Overview
Purpose
Fasting guidelines for children recommend restricting clear fluids for one or two hours before a procedure to reduce pulmonary aspiration. Gastric volumes < 1.5 mL·kg
−1
do not seem to present an increased risk of pulmonary aspiration. Our aim was to quantify the time to achieve a gastric volume < 1.5 mL·kg
−1
after clear fluid ingestion in children.
Methods
We conducted a prospective observational study in healthy volunteers aged 1–14 yr. Participants followed American Society of Anesthesiologists fasting guidelines prior to data collection. Gastric ultrasound (US) was performed in the right lateral decubitus (RLD) position to determine the antral cross-sectional area (CSA). Following baseline measurements, participants consumed 250 mL of a clear fluid. We then performed gastric US at four time intervals: 30, 60, 90, and 120 min. Data were collected following a predictive model for gastric volume estimation using the formula: volume (mL) = −7.8 + (3.5 × RLD CSA) + (0.127) × age (months).
Results
We recruited 33 healthy children aged 2–14 yr. The mean gastric volume per weight (mL·kg
−1
) at baseline was 0.51 mL·kg
−1
(95% confidence interval [CI], 0.46 to 0.57). The mean gastric volume was 1.55 mL·kg
−1
(95% CI, 1.36 to 1.75) at 30 min, 1.17 mL·kg
−1
(95% CI, 1.01 to 1.33) at 60 min, 0.76 mL·kg
−1
(95% CI, 0.67 to 0.85) at 90 min, and 0.58 mL·kg
−1
(95% CI, 0.52 to 0.65) at 120 min.
Conclusion
Our results show that total gastric fluid volume was < 1.5 mL·kg
−1
after 60 min, suggesting that current fasting guidelines for children could be liberalized.
Publisher
Springer International Publishing,Springer Nature B.V
