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Ultrasound assessment of gastric residual volume in pediatric burn patients supplemented with oral carbohydrate solution during preoperative fasting
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Abstract
Objective: This study aimed to evaluate gastric residual volume using antrum ultrasound in pediatric patients who received oral carbohydrate solution during the preoperative fasting period, and to monitor the incidence of aspiration complications during anesthesia.
Subjects and methods: A prospective clinical descriptive study was conducted on 50 pediatric patients aged 10 - 18 years who were scheduled for surgical excision of burn necrosis and skin grafting. Patients received oral carbohydrate solution according to the Ministry of Health’s protocol up to 2 hours before surgery. Antrum ultrasound was performed prior to anesthesia induction to measure the cross-sectional area (CSA), estimate gastric fluid volume using the Perlas formula, and assess gastric content grade based on the Perlas classification. Clinical symptoms and aspiration events were recorded during anesthesia induction, laryngeal mask airway (LMA) placement, and recovery phase (if any).
Results: The mean CSA was 139.30 ± 75.82 mm². The estimated mean gastric fluid volume was 29.14 ± 11.13 ml (0.58 ± 0.18 ml/kg), with no cases exceeding the aspiration risk threshold of 1.5 ml/kg. According to the Perlas classification, 60% of patients were Grade 0, 30% Grade 1, and 10% Grade 2. No aspiration events occurred during anesthesia.
Conclusion: Antrum ultrasound is a reliable method for estimating gastric fluid volume in children. Oral carbohydrate supplementation up to 2 hours before surgery does not increase the risk of excessive gastric fluid accumulation and is not associated with aspiration complications during surgical anesthesia.
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Keywords
Gastric ultrasound, Carbohydrate, Pediatric patients, Preoperative fasting
References
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