Gastric fluid measurement by blind aspiration in paediatric patients: A gastroscopic evaluation

Abstract

Purpose: Numerous investigators have estimated gastric fluid volume using blind aspiration through multi-orificed catheters, but none have confirmed the validity of this technique in infants and children. We sought to validate the accuracy of this technique in a fasted paediatric population by using gastroscopy. Data from several studies were then combined to generate a gastric fluid volume frequency distribution for healthy paediatric patients fasted for surgery. Methods: This is a prospective study of 17 patients aged six months to 11 yr who underwent elective upper endoscopy at a paediatric teaching hospital. Gastric contents were aspirated blindly with a syringe and a 16 or 18F multi-orificed orogastric tube, and the volume of gastric contents removed in the supine and decubitis positions was measured. Residual gastric fluid was aspirated using an endoscope. Data from 611 infants and children enrolled in previously published studies utilizing the same blind aspiration technique were pooled and a gastric fluid volume frequency distribution was created. Results: Blind aspiration removed 97 ± 8% of the total gastric fluid volume. In 661 children presenting for elective surgery, the gastric fluid volume was 0.40 ± 0.45 ml·kg-1. Median volume was 0.27 ml·kg-1, with the 95%ile at 1.25 ml·kg-1 and an upper limit of 4.1 ml·kg-1. Conclusion: Blind aspiration of gastric contents accurately estimates gastric fluid volume for paediatric patients fasted for surgery. Population estimates for gastric fluid volume in otherwise healthy fasted paediatric patients are shown.