Bedside ultrasound assessment of gastric content in children noncompliant with preoperative fasting guidelines: Is it time to include this in our practice?

Ultrasound assessment of gastric contents and volume is gaining popularity in adults and children. At present, a preoperative verbal check is used to determine the fasting status. Due to fear of delay or cancellation of surgery, parents may not disclose noncompliance with fasting guidelines. Pulmonary aspiration of gastric contents is a potential cause of morbidity and mortality. Ultrasound assessment of gastric contents is noninvasive and easy to learn. We present a series of three cases to demonstrate how the use of ultrasound to assess gastric contents in children can provide an objective means for decision-making and impact anesthetic management when preoperative fasting status is uncertain.

[1]  D. Chassard,et al.  Ultrasound assessment of the gastric contents for the guidance of the anaesthetic strategy in infants with hypertrophic pyloric stenosis: a prospective cohort study. , 2016, British journal of anaesthesia.

[2]  A. Perlas,et al.  Ultrasound assessment of gastric volume in the fasted pediatric patient undergoing upper gastrointestinal endoscopy: development of a predictive model using endoscopically suctioned volumes , 2015, Paediatric anaesthesia.

[3]  Cyrus Tse,et al.  Intra- and Interrater Reliability of Ultrasound Assessment of Gastric Volume , 2014, Anesthesiology.

[4]  N. Mitsakakis,et al.  Ultrasound assessment of gastric content and volume. , 2014, British journal of anaesthesia.

[5]  N. Mitsakakis,et al.  Validation of a Mathematical Model for Ultrasound Assessment of Gastric Volume by Gastroscopic Examination , 2013, Anesthesia and analgesia.

[6]  H. Bould,et al.  Parents’ understanding of and compliance with fasting instruction for pediatric day case surgery , 2012, Paediatric anaesthesia.

[7]  R. Klaghofer,et al.  Ultrasonographic gastric antral area and gastric contents volume in children , 2012, Paediatric anaesthesia.

[8]  I. Sporea,et al.  Ultrasound examination of the normal gastrointestinal tract. , 2010, Medical ultrasonography.

[9]  Z. Kain,et al.  Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologist Task Force on Preoperative Fasting. , 1999, Anesthesiology.