![]() The stomach is a āJā-shaped organ divided into four named regions: the cardia, fundus, body, and pylorus. Mastery of gastric ultrasound requires knowledge of the anatomy of the stomach and nearby organs. This information is used to determine the most appropriate timing for elective procedures, anesthetic choice, and airway management approach. The use of gastric ultrasound allows anesthesia providers to differentiate between the full and empty stomach, determine the consistency of gastric contents (solids, thick liquids, clear liquids), and estimate the volume of gastric fluids. Gastric ultrasound is a simple, fast, non-invasive bedside diagnostic test that provides a qualitative and quantitative assessment of gastric contents. Providers also face the challenge of unclear NPO status, as seen in poor historians, patients with dementia, language barriers, and non-compliant patients. No clear guidance on appropriate fasting periods is provided for patients at increased risk of delayed gastric emptying or pulmonary aspiration, such as those with diabetes mellitus, gastroesophageal reflux disease, morbid obesity pregnancy, or recent opioid use. These guidelines recommend that healthy patients fast for a minimum of 2 hours for clear liquids 4 hours for human breastmilk 6 hours for non-human breastmilk, infant formula, or light meals and 8 hours for fried foods, fatty foods, and meat. ![]() The American Society for Anesthesiologists Practice Guidelines for Preoperative Fasting is intended to reduce gastric aspiration risk. The risk of gastric aspiration can be reduced by fasting before planned procedures. The presence of food or liquids in the stomach before the induction of anesthesia is one of the greatest risk factors for perioperative pulmonary aspiration. Aspiration pneumonia among surgical patients is associated with a 4.0-fold increased risk of intensive care admission, a 9-day increase in length of stay, and a 7.6-fold increased risk of in-hospital mortality. Aspiration can lead to hypoxia, bronchospasm, pneumonitis, pneumonia, acute respiratory distress syndrome, and death. Aspiration of gastric contents is a common cause of perioperative morbidity and mortality.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |