• Anahi Perlas, Nicholas Mitsakakis, Louis Liu, Maria Cino, Nidhi Haldipur, Liisa Davis, Javier Cubillos, and Vincent Chan.
• University Health Network, University of Toronto, Toronto Western Hospital, Department of Anesthesia, 399 Bathurst St. Toronto, Ontario, M5T 2S8, Canada. anahi.perlas@uhn.on.ca
• Anesth. Analg.. 2013 Feb 1;116(2):357-63.

IntroductionPulmonary aspiration of gastric contents is a serious perioperative complication. Previous models of ultrasound gastric volume assessment are preliminary and have not been validated by an external "gold standard." In the present study we propose a more accurate model based on prospective data obtained from 108 patients undergoing bedside gastric sonography and upper gastrointestinal endoscopy (UGE).MethodsPatients undergoing elective UGE were randomized to ingest one of 6 predetermined volumes of apple juice after an 8-hour fasting period. A cross-sectional area of the antrum in the right lateral decubitus position (Right lat CSA) was measured by a blinded sonographer following a standardized scanning protocol. Gastric fluid was subsequently suctioned under gastroscopic vision during UGE performed by a blinded gastroenterologist and measured to the nearest milliliter.ResultsData from 108 patients suggest that a previously reported model tends to overestimate gastric volume particularly at low volume states. A new best fit mathematical model to predict gastric fluid volume based on measurements of Right lat CSA is presented. This new model built on a more accurate gold standard can be used to estimate gastric volumes from 0 to 500 mL, in nonpregnant adults with body mass index<40 kg/m2.ConclusionsWe report a new prediction model to assess gastric fluid volume using standard 2-dimentional bedside ultrasound that has several advantages over previously reported models.

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