Gastric Ultrasound for Airway Management in Emergency Patients
8 juni 2026 bijgewerkt door: 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.
Studie Overzicht
Toestand
Voltooid
Conditie
Interventie / Behandeling
Gedetailleerde beschrijving
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).
Studietype
Observationeel
Inschrijving (Werkelijk)
43
Contacten en locaties
In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.
Studie Locaties
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Jakarta Special Capital Region
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Jakarta, Jakarta Special Capital Region, Indonesië, 01430
- RSUPN Cipto Mangunkusumo
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Deelname Criteria
Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Nee
Bemonsteringsmethode
Niet-waarschijnlijkheidssteekproef
Studie Bevolking
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.
Beschrijving
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
Studie plan
Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
Interventie / Behandeling |
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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.
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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).
Andere namen:
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Association between aspiration risk based on gastric ultrasound findings and airway management technique selection
Tijdsspanne: At time of pre-induction assessment (single time point, intraoperative)
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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.
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At time of pre-induction assessment (single time point, intraoperative)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change in Airway Management Plan After Gastric USG
Tijdsspanne: Before and immediately after gastric USG, prior to anesthetic induction
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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.
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Before and immediately after gastric USG, prior to anesthetic induction
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Gastric Residual Volume
Tijdsspanne: At pre-induction assessment
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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).
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At pre-induction assessment
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Gastric Content Type
Tijdsspanne: At pre-induction assessment
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Proportion of patients with each gastric content category: empty, liquid only, solid, or mixed (solid and liquid), as identified by gastric PoCUS.
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At pre-induction assessment
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Fasting Duration and Its Relationship to Gastric Residual Volume
Tijdsspanne: At pre-induction assessment
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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.
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At pre-induction assessment
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American Society of Anesthesiologists (ASA) Physical Status Classification as a factor in airway management decision
Tijdsspanne: At pre-induction assessment
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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.
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At pre-induction assessment
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Trauma Severity Score (ISS) as a factor in airway management decision
Tijdsspanne: At pre-induction assessment
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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.
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At pre-induction assessment
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Glasgow Coma Scale (GCS) score as a factor in airway management decision
Tijdsspanne: At pre-induction assessment
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GCS score recorded at pre-induction assessment and its association with airway management technique selection (RSI vs. non-RSI) after gastric USG.
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At pre-induction assessment
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Presence of clinical risk factors (sepsis, shock, GERD/gastritis) as a factor in airway management decision
Tijdsspanne: At pre-induction assessment
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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.
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At pre-induction assessment
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Medewerkers en onderzoekers
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Sponsor
Studie record data
Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.
Bestudeer belangrijke data
Studie start (Werkelijk)
5 juni 2025
Primaire voltooiing (Werkelijk)
13 augustus 2025
Studie voltooiing (Werkelijk)
13 september 2025
Studieregistratiedata
Eerst ingediend
2 juni 2026
Eerst ingediend dat voldeed aan de QC-criteria
8 juni 2026
Eerst geplaatst (Werkelijk)
10 juni 2026
Updates van studierecords
Laatste update geplaatst (Werkelijk)
10 juni 2026
Laatste update ingediend die voldeed aan QC-criteria
8 juni 2026
Laatst geverifieerd
1 juni 2026
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Pathologische processen
- Ziekte attributen
- Ziekten van de luchtwegen
- Ziekten van het spijsverteringsstelsel
- Gastro-intestinale aandoeningen
- Ademhalingsstoornissen
- Slokdarmaandoeningen
- Slokdarmmotiliteitsstoornissen
- Verslikkingsstoornissen
- Laryngofaryngeale reflux
- Gastro-oesofageale reflux
- Ademhaling Aspiratie
- Pathologische aandoeningen, tekenen en symptomen
- Spoedgevallen
- Ademhaling van de maaginhoud
Andere studie-ID-nummers
- GastricUSG
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
NEE
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Nee
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
Nee
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