Body Position and Ultrasound Examination of the Gastric Antrum (POSIGAST)

Civil Hospices of Lyon

Status: Completed

Conditions: Pulmonary Aspiration of Gastric Contents

Treatments: Other: Qualitative and quantitative assessment of gastric content volume with bed elevation; Other: Qualitative and quantitative assessment of gastric content volume without bed elevation

Study type: Interventional

Funder types: Other

Identifiers

NCT04097236

2019-A01333-54 (Other Identifier)

69HCL19_0244

Details and patient eligibility

About

Pulmonary aspiration of gastric contents is a complication causing significant morbidity and mortality related to anesthesia. Ultrasound examination of the gastric antrum allows the detection of preoperative gastric contents contributing to the preoperative assessment of pulmonary aspiration risk. In particular, this examination is based on the qualitative analysis of gastric contents performed in the supine and in the right lateral decubitus, using a qualitative score which makes it possible to discriminate a low liquid content of a large liquid volume. This score has been described in patients and volunteers installed on a bed without elevation of the upper section of the bed. However, in several studies, this qualitative score has been achieved in the 45° semirecumbent position, which may have affected the diagnostic performance of the examination thus performed, as suggested by the results of a study recently conducted by the investigating team. This study therefore aims to compare the diagnostic performance of the qualitative analysis of the gastric antrum performed in the supine and the right lateral decubitus for the diagnosis of gastric volumes higher than 50 ml and 100 ml, according to the bed angle: 45 ° elevation or no elevation of the upper section of the bed.

Enrollment: 21 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Adults 18 years old or older
• Last consumption of solids at least 6 hours before the start of the study, last consumption of clear fluids at least 2 hours before the start of the study
• Informed consent must have been signed.
• No significant medical history (American Society of Anesthesiologists (ASA) class 1)

Exclusion criteria

• Adult unable to give informed consent
• Previous gastrointestinal surgery
• Medication affecting gastric motility
• Digestive diseases, gastroparesis, diabetes mellitus with insulin
• Pregnancy or breastfeeding
• Obesity (Body Mass Index (BMI) ≥ 30 kilograms/meter² (kg/m²))

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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21 participants in 2 patient groups

45° semirecumbent position

Active Comparator group

Treatment:

Other: Qualitative and quantitative assessment of gastric content volume with bed elevation

No elevation of the upper section of the bed

Active Comparator group

Treatment:

Other: Qualitative and quantitative assessment of gastric content volume without bed elevation