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ORIGINAL ARTICLE
Year : 2021  |  Volume : 65  |  Issue : 4  |  Page : 289-294

Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study


1 Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India
2 Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India

Correspondence Address:
Priya Ranganathan
Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Dr. E Borges Road, Parel, Mumbai - 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_1291_20

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Background and Aims: Ultrasonography (USG) is used to evaluate gastric residual volume (GRV); however, this technique may have inter-assessor variability. This study aimed to measure GRV in three groups of fasted patients 2 h after they received 200 mL of water, clear apple juice or apple-flavoured oral rehydration solution (ORS) and to determine inter-assessor reliability of USG-guided GRV measurement. Methods: We randomised 90 adult patients planned for elective cancer surgery, with no risk factors for delayed gastric emptying, to receive 200 mL of water, clear apple juice or apple-flavoured ORS after overnight fasting. Two hours later, two blinded assessors (a trained anaesthesiologist and a radiologist) independently determined USG-guided GRV. The primary outcome was GRV measured by the radiologist. The secondary outcome was inter-assessor correlation and agreement in GRV measurements. Results: There was no statistically significant difference in median GRV between groups (apple-flavoured ORS 74.8 mL, apple juice 63.7 mL, and water 62.1 mL, P = 0.11). We found poor correlation between measurements of radiologist and anaesthesiologist (Intra-class correlation coefficient 0.3, 95% confidence intervals 0.09 to 0.48, P value 0.002). The average (mean) bias was 5.4 mL (standard deviation 42.3 mL) and the 95% limits of agreement were -79.2 ml to +90 ml. Conclusion: Patients receiving 200 mL of water, clear apple juice or apple-flavoured ORS had comparable GRV after 2 h. There was poor correlation and agreement between GRV measurements of different assessors, indicating that more training may be required for anaesthesiologists to attain proficiency in the quantitative assessment of GRV.


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