Indian Journal of Anaesthesia

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


Jeson Rajan Doctor1, Pramila Chandan1, Nitin Shetty2, Kunal Gala2, Priya Ranganathan1 
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

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.


How to cite this article:
Doctor JR, Chandan P, Shetty N, Gala K, Ranganathan P. Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study.Indian J Anaesth 2021;65:289-294


How to cite this URL:
Doctor JR, Chandan P, Shetty N, Gala K, Ranganathan P. Ultrasound-guided assessment of gastric residual volume in patients receiving three types of clear fluids: A randomised blinded study. Indian J Anaesth [serial online] 2021 [cited 2021 Jul 29 ];65:289-294
Available from: https://www.ijaweb.org/article.asp?issn=0019-5049;year=2021;volume=65;issue=4;spage=289;epage=294;aulast=Doctor;type=0