SEARCHCOHORTcritical care, emergency medicine

cohort·critical care, emergency medicine, surgery, observational study, clinical nutrition·PMC10024819

Inter-observer and intra-observer variability in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition

The Ultrasound Journal · 3 authors, 7 centres

AI SUMMARY

FIDELITY 100%

This summary was generated by AI from a single paper. It has not been reviewed by a clinician and is not clinical advice. Verify against the source before acting on it.

AGENT 01 · STRUCTURED SUMMARY

TRACE TO SOURCE

“

TL;DR

This study evaluated the agreement between two examiners using bedside ultrasound to assess gastric content and volume in 41 critically ill patients. It found good intra- and inter-observer reliability for both qualitative and quantitative assessments.

Full summary

358 CHARS

A prospective correlation study was conducted in 41 critically ill, mechanically ventilated ICU patients receiving enteral nutrition. The findings suggest that bedside gastric ultrasound is a reliable tool for assessing gastric content in this population, though further research is needed to determine its predictive value for enteral nutrition intolerance.

STUDY TYPE

cohort

SPECIALTY

critical care

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10024819

Inter-observer and intra-observer variability in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition

The Ultrasound Journal

READ THE FULL PAPER

ABSTRACT

Background The assessment of gastric content and volume using bedside ultrasound (US) has become a useful tool in emergency departments, anesthesiology departments and inpatient wards, as it provides a rapid and dynamic assessment of the gastric content of patients, which, allows making decisions regarding the risk of regurgitation or the need to adjust the strategy used to induce general anesthesia in patients with a full stomach. This assessment consists of two evaluations: a qualitative one, in which the status of the antrum, in terms of gastric content, is classified into three categories (empty, liquid content and full), and a quantitative one, where gastric volume is estimated. The objective of this study was to estimate the intra-observer and inter-observer agreement in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition. Results A total of 41 patients were included and each examiner performed 64 gastric US ( n = 128). Participants’ average age was 56.5 years (SD ± 12.6) and 63.4% were men. Regarding the qualitative evaluation of the antrum, in supine position both examiners classified the gastric content as grade 0 in 1 gastric US (1.5%), grade 1 in 4 gastric US (6.2%) and grade 2 in 59 (92.1%). Regarding intra-observer variability in the measurement of the area of the antrum, Lin's concordance correlation coefficient (CCC), the difference of means between measurements and the 95% limits of agreement of Bland and Altman values were 0.95 (95% CI 0.940–0.977), − 0.47 cm 2 (SD ± 1.64) and − 3.70 cm 2 to 2.75 cm 2 , respectively, in EC1, and 0.94 (95% CI 0.922–0.973), − 0.18 cm 2 (SD ± 2.18) and − 4.47 cm 2 to 4.09 cm 2 in EC2. Concerning to inter-observer variability (EC1 vs EC2) in the measurement of the area of the antrum and of gastric volume, the following CCC, mean difference between measurements and 95% limits of agreement of Bland and Altman values were obtained: measurement of the area of the antrum: 0.84 (95% CI 0.778–0.911), − 0.86 cm 2 (SD ± 3.38) and − 7.50 cm 2 to 5.78 cm 2 ; gastric volume measurement: 0.84 (95% CI 0.782–0.913), − 12.3 mL (SD ± 49.2) and − 108.8 mL to 84.0 mL. Conclusions The assessment of gastric content and volume using bedside US in critically ill patients on mechanical ventilation and receiving enteral nutrition showed a good intra and inter-rater reliability. Most of the patients included in the study had a high risk of pulmonary aspiration, since, according to the results of the gastric US evaluation, they had gastric volumes > 1.5 mL/kg.

CITATION EXPORT

Héctor Andrés Ruiz Ávila, Carmelo José Espinosa Almanza, Cindy Yohana Fuentes Barreiro. Inter-observer and intra-observer variability in ultrasound assessment of gastric content and volume in critically ill patients receiving enteral nutrition. The Ultrasound Journal. (2023). https://doi.org/10.1186/s13089-023-00312-x

AUTHORS

3 · 7 CENTRES

Héctor Andrés Ruiz Ávila, Carmelo José Espinosa Almanza, Cindy Yohana Fuentes Barreiro

1grid.511227.20000 0005 0181 2577Anestesiologo-Intensivista, Unidad de Cuidados Intensivos, Hospital Universitario Nacional de Colombia, Bogotá, D.C Colombia
2grid.412208.d0000 0001 2223 8106Docente Asociado Universidad Militar Nueva Granada, Bogotá, D.C Colombia
3grid.10689.360000 0001 0286 3748Docente Adjunto Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
4grid.10689.360000 0001 0286 3748Grupo de Investigación en Cuidados Intensivos de la Universidad Nacional de Colombia (GICI-UN), Bogotá, Colombia
5grid.511227.20000 0005 0181 2577Grupo de Interés en Ultrasonido Enfocado HUN-UNAL, Bogotá, Colombia
6grid.10689.360000 0001 0286 3748Docente Auxiliar Departamento de Medicina Interna, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia
7grid.10689.360000 0001 0286 3748Departamento de Anestesiología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, Colombia