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Gastric Ultrasound for Airway Management in Emergency Patients

8. juni 2026 opdateret af: Raden Besthadi Sukmono, Indonesia University

Airway Management Selection Based on Gastric Content and Residual Volume Assessment in Emergency Patients at RSCM: An Ultrasonography Study

This prospective observational cohort study evaluates the association between gastric residual content and volume, assessed by point-of-care gastric ultrasound (PoCUS), and the choice of airway management technique (Rapid Sequence Intubation vs. non Rapid Sequence Intubation) in adult emergency surgical patients at Rumah Sakit Cipto Mangunkusumo (RSCM). Aspiration risk in emergency patients is a critical concern, and this study examines whether objective ultrasonographic findings change clinical decision-making compared to traditional clinical assessment alone.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Emergency patients frequently have delayed gastric emptying, increasing aspiration risk during airway management. Gastric PoCUS allows non-invasive, bedside assessment of gastric content (empty, liquid, solid, or mixed) and volume. This study quantifies gastric antrum cross-sectional area (CSA) using the Perlas formula (GV = 27.0 + 14.6 × CSA - 1.28 × age) and reports whether USG findings influenced the anesthesiologist's plan (RSI or non-RSI).

Undersøgelsestype

Observationel

Tilmelding (Faktiske)

43

Kontakter og lokationer

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Studiesteder

  • Indonesien
    • Jakarta Special Capital Region
      • Jakarta, Jakarta Special Capital Region, Indonesien, 01430
        • RSUPN Cipto Mangunkusumo

Deltagelseskriterier

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Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult emergency surgical patients (age >18 years) requiring airway management under general anesthesia at the Emergency Operating Room of RSUPN Dr. Cipto Mangunkusumo (RSCM), Jakarta, Indonesia. The population includes both trauma (62.8%) and non-trauma (37.2%) emergency cases. Patients were enrolled consecutively from July to August 2025. Patients with conditions that could confound gastric ultrasound assessment or airway management decisions were excluded.

Beskrivelse

Inclusion Criteria:

  • Emergency patients requiring airway management in the Emergency Operating Room
  • Age >18 years

Exclusion Criteria:

  • Pregnancy
  • Morbid obesity (BMI >40 kg/m²)
  • History of prior gastric or esophageal surgery
  • Duodenal tube in situ
  • Maxillofacial trauma or anticipated difficult airway
  • Inability to adequately visualize the gastric antrum on ultrasound

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Emergency Surgical Patients
Adult emergency surgical patients (age >18 years) requiring airway management at the Emergency Operating Room of RSUPN Dr. Cipto Mangunkusumo (RSCM), who underwent preoperative gastric point-of-care ultrasound (PoCUS) to assess gastric content type and residual volume prior to anesthetic induction.
Enhed: Preoperative Gastric Point-of-Care Ultrasound (PoCUS)
Gastric antrum ultrasound performed using a low-frequency transducer (2-5 MHz; SonoSite M-Turbo or Lumify Philips) in the supine position before anesthetic induction. The antrum cross-sectional area (CSA) was measured during the relaxation phase between two peristaltic contractions, calculating cranio-caudal (CC) and antero-posterior (AP) diameters. Gastric residual volume (GRV) was calculated using the Perlas formula: GV = 27.0 + 14.6 × CSA - 1.28 × age (years). Gastric content was classified as empty, liquid, solid, or mixed. Aspiration risk was categorized as high (GRV ≥1.5 ml/kg or solid content) or low (GRV <1.5 ml/kg or empty).
Andre navne:
  • Gastrisk ultralyd
  • Gastric USG
  • Bedside Gastric Sonography

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Association between aspiration risk based on gastric ultrasound findings and airway management technique selection
Tidsramme: At time of pre-induction assessment (single time point, intraoperative)
Proportion of patients in whom airway management technique (Rapid Sequence Intubation vs. non Rapid Sequence Intubation) was associated with aspiration risk category (high vs. low) determined by preoperative gastric Point-of-Care Ultrasound (PoCUS) findings. Aspiration risk classified as high if Gastric Residual Volume (GRV) ≥1.5 ml/kg or solid gastric content; low if GRV <1.5 ml/kg or empty stomach. Analyzed using chi-square test.
At time of pre-induction assessment (single time point, intraoperative)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Airway Management Plan After Gastric USG
Tidsramme: Before and immediately after gastric USG, prior to anesthetic induction
Comparison of airway management plan (RSI vs. non-RSI) before and after disclosure of gastric USG findings to the treating anesthesiologist. Analyzed using McNemar's paired categorical test.
Before and immediately after gastric USG, prior to anesthetic induction
Gastric Residual Volume
Tidsramme: At pre-induction assessment
Gastric residual volume calculated using the Perlas formula: GV = 27.0 + 14.6 × CSA - 1.28 × age (years), based on antrum cross-sectional area (CSA) measured from cranio-caudal (CC) and antero-posterior (AP) diameters. Reported as mean ± SD or median (range).
At pre-induction assessment
Gastric Content Type
Tidsramme: At pre-induction assessment
Proportion of patients with each gastric content category: empty, liquid only, solid, or mixed (solid and liquid), as identified by gastric PoCUS.
At pre-induction assessment
Fasting Duration and Its Relationship to Gastric Residual Volume
Tidsramme: At pre-induction assessment
Fasting duration categorized as <8 hours, 8-12 hours, or >12 hours since last solid food intake, and its relationship to gastric residual volume and aspiration risk classification on USG.
At pre-induction assessment
American Society of Anesthesiologists (ASA) Physical Status Classification as a factor in airway management decision
Tidsramme: At pre-induction assessment
Proportion of patients in each American Society of Anesthesiologists (ASA) class (I, II, III, IV) and its association with airway management technique selection (RSI vs. non-RSI) after gastric USG, analyzed using chi-square test.
At pre-induction assessment
Trauma Severity Score (ISS) as a factor in airway management decision
Tidsramme: At pre-induction assessment
Injury Severity Score (ISS) categorized as severe (ISS ≥15) or mild-moderate (ISS <15) and its association with airway management technique selection (RSI vs. non-RSI) after gastric USG, analyzed using chi-square test.
At pre-induction assessment
Glasgow Coma Scale (GCS) score as a factor in airway management decision
Tidsramme: At pre-induction assessment
GCS score recorded at pre-induction assessment and its association with airway management technique selection (RSI vs. non-RSI) after gastric USG.
At pre-induction assessment
Presence of clinical risk factors (sepsis, shock, GERD/gastritis) as a factor in airway management decision
Tidsramme: At pre-induction assessment
Proportion of patients with each clinical risk factor (sepsis, hemorrhagic shock, GERD/gastritis) and its association with airway management technique selection (RSI vs. non-RSI) after gastric USG, analyzed using chi-square or Fisher's exact test.
At pre-induction assessment

Samarbejdspartnere og efterforskere

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Sponsor

Indonesia University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

5. juni 2025

Primær færdiggørelse (Faktiske)

13. august 2025

Studieafslutning (Faktiske)

13. september 2025

Datoer for studieregistrering

Først indsendt

2. juni 2026

Først indsendt, der opfyldte QC-kriterier

8. juni 2026

Først opslået (Faktiske)

10. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

10. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. juni 2026

Sidst verificeret

1. juni 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • GastricUSG

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