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The presence of gastric contents makes an aspiration event more likely , and as a result, preoperative fasting guidelines are designed to provide adequate time for gastric emptying in patients undergoing surgery. this study will be conducted to assess the gastric volume and content with the help of ultrasound in fasted pediatric patients scheduled for elective surgeries
it is unknown how many patients have gastric volumes that place them at increased risk of aspiration despite adequate fasting.
There is a growing interest in the use of bedside ultrasonography to assess gastric content and volume. It has been suggested that the gastric antrum in particular can be assessed reliably by sonography.
hence, this study will be conducted to assess the gastric volume and content with the help of ultrasound in fasted pediatric patients scheduled for elective surgeries which will help to detect accuracy of preoperative fasting hours.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| standard fasting | Active Comparator | preoperative fasting according to 6-4-2 regimen then preoperative bedside gastric ultrasound assessment will be done |
|
| liberal fasting | Experimental | preoperative fasting according to 6-4-0 regimen then preoperative bedside gastric ultrasound assessment will be done |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| liberal fasting | Other | preoperative fasting according to 6-4-0 regimen then qualitative and quantitative preoperative gastric ultrasound assessment will be done to evaluate the proportion of patients with risky stomach |
| Measure | Description | Time Frame |
|---|---|---|
| proportion of patients with a risky stomach. | bedside ultrasound to estimate the gastric volume in milliliter | immediately preoperative |
| Measure | Description | Time Frame |
|---|---|---|
| gastric content quality | bedside ultrasound to determine the nature of gastric content (solid or fluid) | immediately preoperative |
| fasting hours | actual and prescribed preoperative fasting |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Mona R Elghamry, MD | Tanta University, Faculty of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University, Faculty of Medicine | Tanta | 31527 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39711127 | Derived | Elghamry MR, Elkeblawy AM, Alshawadfy AM, Ramadan KM. Gastric ultrasound assessment of two preoperative fasting regimens in pediatric patients: A randomized clinical trial. Acta Anaesthesiol Scand. 2025 Jan;69(1):e14566. doi: 10.1111/aas.14566. |
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statistics of demographic data, gastric volume, fasting hours, type of last meal, episode of gastric regurgitation
the IPD will be shared after finishing and publication of the study and it will be available for 6 months
the IPD will be available for scientific research only upon e-mail request which will be sent to principal investigator (drmonagh19802000@gmail.com)
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| standard fasting | Other | preoperative fasting according to 6-4-2 regimen then qualitative and quantitative preoperative gastric ultrasound assessment will be done to evaluate the proportion of patients with risky stomach |
|
| the new preoperative fasting (6 hours for solids, 4 hours for milk, non-clear fluid or light breakfast, and 0 hours for clear fluids) |
| type of last meal | last meal (heavy solid,light solid,non clear fluid,or clear fluid) | last meal within 24 hours preoperative |
| episodes of gastric regurgitation, vomiting , aspiration | incidence of regurgitation, vomiting , aspiration if regurgitation happened patients will be followed up postoperative clinically and radiologically | during induction or emergence from anesthesia (within 30 minutes) |
| gastric volume | quantitative gastric ultrasound assessment (gastric volume, volume/weight, antral cross sectional area) | immediately preoperative (within 30 minutes) |
| parents satisfaction | parents' satisfaction is evaluated using a 5-point Likert scale | after PACU discharge (within 2 hours postoperative) |
| cancellation | rate of surgery cancellation | decision will be taken within 30 minutes preoperative |
| adverse events | adverse events related to fasting duration | preoperative or postoperative |