Point-of-Care Gastric Ultrasound for Estimation of Aspiration Risk

Abstract

Pulmonary aspiration of gastric contents remains a serious complication during the perioperative period as well as during airway management in emergency and critical care settings. A full stomach is a major determinant for gastroesophageal regurgitation and aspiration during anesthesia and airway management. Preoperative fasting recommendations are aimed at ensuring an empty stomach in elective surgical patients. However, despite strict adherence to preoperative fasting guidelines, about 6% of elective surgical patients present with a full stomach. Adequate preoperative fasting does not always ensure an empty stomach in patients with comorbidities or drugs that delay gastric emptying and is not practical in urgent or emergent situations. By visualizing the gastric contents (empty or containing fluid or solids), the risk of pulmonary aspiration can be more accurately determined than by relying solely on predefined fasting times and clinical history. Point-of-care gastric ultrasound (POCGUS) is now rapidly emerging as a diagnostic tool that allows quantification of gastric contents. POCGUS is feasible in both non-obese and obese adults and in pregnant and pediatric patients. A protocolized implementation of POCGUS is not only useful for anesthesiologists to aid perioperative shared clinical decision-making during anesthesia care of surgical patients but can also be of importance to physicians in emergency department and critical care settings during management of the patient’s airway.

The authors' abstract, as published at the source. CRC Press eBooks, 2025 · DOI ↗