50 Participants Needed

Gastric Ultrasound for Surgery Patients

AC
GC
LM
Overseen ByLaura M Chiang, MD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Dartmouth-Hitchcock Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This is a case series study using gastric ultrasound in critically ill patients to quantify gastric residual volumes to compare the efficacy of different NPO protocols.

Do I have to stop taking my current medications for the trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What safety data exists for gastric ultrasound in surgery patients?

The research does not provide specific safety data for gastric ultrasound in surgery patients. However, it highlights the utility and growing application of gastric ultrasound (POCUS) in assessing gastric content, predicting fasting adequacy before surgery, and its potential use in emergency and general anesthesia settings. The studies suggest that gastric ultrasound is a safe and useful tool for clinical decision-making, but specific safety data is not detailed in the provided abstracts.12345

Is the treatment in the trial 'Gastric Ultrasound for Surgery Patients' a promising treatment?

Yes, gastric ultrasound is a promising treatment because it helps doctors quickly and safely check what's in a patient's stomach. This can be very useful in emergencies and surgeries, making it easier to make the right decisions for patient care.16789

What data supports the idea that Gastric Ultrasound for Surgery Patients is an effective treatment?

The available research shows that Gastric Ultrasound is effective because it helps doctors see what's in a patient's stomach before surgery. This can be important to prevent complications like aspiration, where stomach contents accidentally enter the lungs. For example, one study found that it can predict if a patient has fasted enough before surgery. Another study highlighted its use in children to check for stomach contents before sedation, which is important for safety. Overall, these studies suggest that Gastric Ultrasound is a useful tool for making surgeries safer by providing important information about the stomach's contents.1261011

Who Is on the Research Team?

LM

Laura M Chiang, MD

Principal Investigator

Dartmouth-Hitchcock Medical Center

Are You a Good Fit for This Trial?

This trial is for adults over 18 in the ICU who need general anesthesia or sedation and already have a cuffed breathing tube in place. It's not for those with upper GI tract issues, history of gastric perforation, without a proper breathing tube, or women past their first trimester of pregnancy.

Inclusion Criteria

You are 18 years old or older, in the intensive care unit, and need to be put to sleep or sedated for a procedure with a breathing tube already in place.

Exclusion Criteria

You have a known upper stomach problem that could make it hard to measure how much is in your stomach.
You have a history of a hole in your stomach.
You do not already have a special breathing tube in place.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Patients undergo gastric ultrasound to quantify gastric residual volumes and compare NPO protocols

16 months

Follow-up

Participants are monitored for peri-operative aspiration events and other outcomes

4 months

What Are the Treatments Tested in This Trial?

Interventions

  • Gastric Ultrasound
Trial Overview The study uses gastric ultrasound on ICU patients to measure how much stomach content they have. This helps check if 'nothing by mouth' (NPO) guidelines before procedures are effective at different times.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Standard ASA NPO ProtocolExperimental Treatment1 Intervention
Patients will be made NPO at midnight prior to date of surgery.
Group II: Liberal Feeding ProtocolExperimental Treatment1 Intervention
Patients will be fed enterally up until call to OR at which time their stomachs will be decompressed with a pre-existing gastric tube.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Dartmouth-Hitchcock Medical Center

Lead Sponsor

Trials
548
Recruited
2,545,000+

Published Research Related to This Trial

Gastric ultrasound (US) is an emerging tool in point-of-care ultrasound (POCUS) that allows for direct measurement of a patient's gastric content, which can enhance clinical decision-making, especially in anesthesia.
The review highlights the historical development and current applications of gastric US, suggesting its potential for use in emergency departments to improve patient assessment and management.
Point-of-Care Ultrasound to Assess Gastric Content.Moake, MM., Jackson, BF., Presley, BC.[2021]
In a study of 116 children aged 2 to 17 years, 69% were found to have a 'full stomach' (defined as having solid contents or more than 1.2 mL/kg of liquid) before procedural sedation, despite a median fasting time of 5.8 hours.
Each additional hour of fasting slightly reduced the odds of having a full stomach, but fasting time alone was not a reliable predictor of gastric contents, suggesting that gastric point-of-care ultrasound (POCUS) could be a valuable tool for assessing risk before sedation.
"Full Stomach" Despite the Wait: Point-of-care Gastric Ultrasound at the Time of Procedural Sedation in the Pediatric Emergency Department.Leviter, J., Steele, DW., Constantine, E., et al.[2020]
Gastric point-of-care ultrasound (POCUS) is a reliable and effective tool in pediatric settings, particularly for assessing gastric emptying and volume, diagnosing foreign body ingestion, and confirming nasogastric tube placement, based on a review of 70 studies.
The use of gastric POCUS can optimize clinical management in acute and critically ill children by providing rapid and accurate assessments, potentially reducing the need for more invasive procedures and minimizing radiation exposure, although further research is needed in critically ill pediatric populations.
Gastric Point-of-Care Ultrasound in Acutely and Critically Ill Children (POCUS-ped): A Scoping Review.Valla, FV., Tume, LN., Jotterand Chaparro, C., et al.[2023]

Citations

Point-of-Care Ultrasound to Assess Gastric Content. [2021]
"Full Stomach" Despite the Wait: Point-of-care Gastric Ultrasound at the Time of Procedural Sedation in the Pediatric Emergency Department. [2020]
Gastric Point-of-Care Ultrasound in Acutely and Critically Ill Children (POCUS-ped): A Scoping Review. [2023]
Point-of-care gastric ultrasound and aspiration risk assessment: a narrative review. [2019]
Feasibility and Utility of Routine Point-of-Care Gastric Ultrasonography in Patients Undergoing Upper Gastrointestinal Endoscopy Procedures: A Prospective Cohort Study. [2023]
Accuracy of point-of-care intestinal ultrasound for Crohn's disease. [2022]
[POCUS is a great asset to general practice]. [2021]
Point of care ultrasonography in the pediatric emergency department. [2018]
The Use of Lung Ultrasound in Acute Medicine. [2020]
10.United Statespubmed.ncbi.nlm.nih.gov
Accuracy of ultrasound for the diagnosis of acute appendicitis in the emergency department: A systematic review. [2023]
Correspondence - Evaluation of a basic point-of-care ultrasound course for residents in internal medicine. [2022]
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