A pilot study of ultrasound evaluation of gastric emptying in patients with end‐stage renal failure: a comparison with healthy controls

• Published in: Anaesthesia 2017-06, Vol.72 (6), p.714-718
• Main Authors: Chen, C., Liu, L., Wang, C. Y., Choi, S.‐W., Yuen, V. M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Anatomy, Cross-Sectional; Anesthesia; antrum; Digestive system; Emptying; End-stage renal disease; end‐stage renal failure; Evaluation; Female; Gastric Emptying; gastric ultrasound; Gastrointestinal Contents; Grading; Health risks; Healthy Volunteers; Humans; Kidney diseases; Kidney Failure, Chronic - diagnostic imaging; Male; Middle Aged; Patient Positioning; Patients; Pilot Projects; Point-of-Care Systems; Prospective Studies; Pyloric Antrum - diagnostic imaging; Quality; Renal failure; Risk analysis; Risk factors; Scanning; Stomach; Stomach - diagnostic imaging; Supine Position; Ultrasonic imaging; Ultrasonography; Ultrasound
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.13869

Summary This prospective study was designed to evaluate gastric volume and content in patients with renal failure and healthy controls after an overnight fast, immediately after a light meal and at 6 h after the meal. Thirty subjects in each group were recruited. At each scanning session, gastric antral cross‐sectional area was measured in the supine recumbent and right lateral decubitus positions, and a qualitative assessment of gastric contents was made using the Perlas three‐point grading system. Six hours after the meal, the mean (SD) antral cross‐sectional area in the supine position was 471 (195) mm2 in patients with renal failure and 319 (106) mm2 in healthy controls (p = 0.028), whereas in the right lateral position it was 756 (320) and 521 (180) mm2, respectively (p = 0.21). In terms of the qualitative assessments of gastric contents, all subjects had an empty stomach after an overnight fast. Five patients with renal failure and no controls had Perlas grade 2 images, indicating significant gastric contents, 6 h after a meal (p = 0.026). This study supports the use of bedside gastric ultrasound as a point‐of‐care test for patients with known risk factors for delayed gastric emptying.