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This is a case series study using gastric ultrasound in critically ill patients to quantify gastric residual volumes to compare the efficacy of different NPO protocols.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard ASA NPO Protocol | Experimental | Patients will be made NPO at midnight prior to date of surgery. |
|
| Liberal Feeding Protocol | Experimental | Patients will be fed enterally up until call to OR at which time their stomachs will be decompressed with a pre-existing gastric tube. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gastric Ultrasound | Diagnostic Test | Gastric ultrasound in the supine and right lateral decubitus position for patients going for operative intervention with a protected airway. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Gastric Residual Volumes | Quantification of gastric residual volumes as measured in milliliters using antral cross-sectional areas and semi-quantitative gastric volumes using standardized grading scores. | Within one hour of operative intervention. |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of two different NPO protocol populations | Comparing standard ASA NPO protocol vs liberal, feed-up-until-call to OR protocol as defined by comparison of gastric volumes (mLs). | Within four months of study completion, 16 months from study start |
| Peri-operative aspiration events |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Laura M Chiang, MD | Contact | 6036500360 | laura.m.chiang@hitchcock.org | |
| Laura M Chiang, MD | Contact | 6036505922 | laura.m.chiang@hitchcock.org |
| Name | Affiliation | Role |
|---|---|---|
| Laura M Chiang, MD | Dartmouth-Hitchcock Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Dartmouth Hitchcock Medical Center | Recruiting | Lebanon | New Hampshire | 03766 | United States |
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| ID | Term |
|---|---|
| D016638 | Critical Illness |
| D011015 | Pneumonia, Aspiration |
| D006963 | Hyperphagia |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011014 | Pneumonia |
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Patients will be assigned to be NPO after midnight (standard protocol) or feed up until call to OR then decompressed (liberal protocol).
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Number of aspiration events per number of operative interventions. |
| Within four months of study completion, 16 months from study start |
| Estimation of the amount of enteral nutrition lost prior to surgery using the different NPO protocols | Calculation of enteral nutrition held during NPO time in kilocalories. | Zero to sixteen hours prior to surgery |
| D012141 | Respiratory Tract Infections |
| D007239 | Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D012817 | Signs and Symptoms, Digestive |
| D012816 | Signs and Symptoms |