Avaliação do conteúdo gástrico pela ultrassonografia
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Data
2016-02-26
Autores
Carmona, Bruno Mendes [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Justificativas e objetivos: O jejum pré-operatório adequado é fundamental na prevenção da aspiração pulmonar do conteúdo gástrico. As diretrizes recomendam que este período de jejum seja de acordo com o tipo de alimento ou líquido ingerido. Esta pesquisa avaliou o volume do conteúdo gástrico e suas características físicas por meio da ultrassonografia após períodos de jejum pré-estabelecidos para alimentos sólidos e líquidos em voluntários sadios. Métodos: Realizamos um estudo prospectivo, crossover, com 17 voluntários, com estado físico ASA I ou II. Cada participante realizou jejum de 10 h. Em seguida, foi submetido a ultrassonografia do abdome de controle (momento C), ingestão do alimento sorteado (sólido ou líquido), ultrassonografia após 10 min (momento 0) e a cada hora (momentos 1 a 6) após a ingestão do alimento até 6 h ou até o momento que que o o estômago estivesse completamente vazio novamente. Resultados: No Momento C (controle) todos estavam com o estômago vazio. No momento zero os volumes de líquido e sólido foram semelhantes. Nos momentos subsequentes, o esvaziamento gástrico do líquido foi mais rápido que do sólido, havendo diferença estatística significativa nos momentos 1, 2 e 3 (p < 0,001). A partir do momento 4, apenas o alimento sólido foi detectado pela ultrassonografia. Conclusão: A ultrassonografia pode avaliar o conteúdo gástrico em tempo real, pode estimar o volume do conteúdo gástrico distinguir suas características de forma objetiva, sem a necessidade de colaboração ou obtenção de informações adicionais. O examinador deve seguir as recomendações quanto ao posicionamento do voluntário, à sonda utilizada e as medidas obtidas.
Justification and objectives: Proper pre-surgical fasting is fundamental to the prevention of pulmonary aspiration of gastric content. The guidelines recommend that such a period of fasting may fit the type of ingested food or liquid. This study has evaluated the volume of gastric content and its physical characteristics through ultrasound after pre-established periods of fasting to solid and liquid food in healthy volunteers. Methods: We conducted a prospective study, crossover, with 17 volunteers, with ASA I or II physical state. Each participant performed 10 hour fasting. After, they were submitted to a control abdominal ultrasound (moment C), sorted ingestion of food (solid or liquid), ultrasound after 10 minutes (moment 0) and hourly (times 1-6) after ingestion of up 6 h or until such time that the the stomach was completely empty again Results: At moment C (Control), all of them had empty stomachs. At moment Zero, the volumes of liquid and solid were similar. At the following moments, gastric emptying of liquid was faster than the solid one, with a significant statistics difference at moments 1, 2 and 3 (p<0.001). Up from moment 4, only the solid food was detectable by ultrasound. Conclusion: Ultrasound may evaluate gastric content in real time, estimate the volume of gastric content, and distinguish its characteristics in an objective way, without the need for collaboration or obtaining additional information. The examiner should follow the recommendations in the placement of the volunteer, the probe to used and the measurements.
Justification and objectives: Proper pre-surgical fasting is fundamental to the prevention of pulmonary aspiration of gastric content. The guidelines recommend that such a period of fasting may fit the type of ingested food or liquid. This study has evaluated the volume of gastric content and its physical characteristics through ultrasound after pre-established periods of fasting to solid and liquid food in healthy volunteers. Methods: We conducted a prospective study, crossover, with 17 volunteers, with ASA I or II physical state. Each participant performed 10 hour fasting. After, they were submitted to a control abdominal ultrasound (moment C), sorted ingestion of food (solid or liquid), ultrasound after 10 minutes (moment 0) and hourly (times 1-6) after ingestion of up 6 h or until such time that the the stomach was completely empty again Results: At moment C (Control), all of them had empty stomachs. At moment Zero, the volumes of liquid and solid were similar. At the following moments, gastric emptying of liquid was faster than the solid one, with a significant statistics difference at moments 1, 2 and 3 (p<0.001). Up from moment 4, only the solid food was detectable by ultrasound. Conclusion: Ultrasound may evaluate gastric content in real time, estimate the volume of gastric content, and distinguish its characteristics in an objective way, without the need for collaboration or obtaining additional information. The examiner should follow the recommendations in the placement of the volunteer, the probe to used and the measurements.
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Palavras-chave
Ultrassonografia, Aspiração respiratória, Jejum, Período pós-operatório, Ultrassonografy, Fasting, Postoperative period