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Gastric Ultrasound of Diabetic and Non-Diabetic Patients Following Preoperative Fasting Instructions

Conditions
Diabetes Mellitus Type 2
Diabetes Mellitus
Diabetes Mellitus Type 1
Diabetes
Registration Number
NCT02888951
Lead Sponsor
University Health Network, Toronto
Brief Summary

This study evaluates the amount of fluid remaining in the stomach of diabetic patients after a standard fasting period, and compare it with non-diabetic patients coming for elective surgical procedures.

Detailed Description

Any surgical procedure carries an inherent risk of pulmonary aspiration. Food or liquid from the stomach might be forced back up the throat from where it could enter the lungs (aspiration) resulting in serious complications prolonging the hospital stay or in extreme circumstances death.

The risk of this is slightly higher in diabetics when compared to non-diabetics as the emptying of contents from the stomach is slightly delayed. This is why people going for surgery are asked not to eat for a specific time before their surgery. Anesthesiologists have recently developed an ultrasound test to determine if there is content in a patient's stomach and how much. This test involves an ultrasound examination of the abdomen and taking some measurements on the ultrasound screen.

This study aims to evaluate the amount of fluid remaining in the stomach of diabetic patients after a standard fasting period, and compare it with non-diabetic patients coming for elective surgical procedures. The investigators also aim to find an association between the type and duration of diabetes mellitus with residual gastric volume. Episodes of intra-operative regurgitation, vomiting or aspiration will also be documented.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
240
Inclusion Criteria
  • Patients scheduled for elective surgery aged 18 to 85 years
  • American Society of Anesthesia physical status classification I to III
  • Body mass index < 40 kg/ cm2.
Exclusion Criteria
  • Pregnancy (currently or within the past 3 months)
  • Previous surgery of the upper gastrointestinal tract
  • Achalasia

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Volume of Gastric ContentsLess than two hour prior to surgery

A "full stomach" is defined as one containing a) solid or thick fluid content or b) \> 1.5 mL/kg of clear fluid.

There are 4 categories regarding gastric contents:

1. Empty Stomach

2. Grade 1 Clear Fluid (fluid only observed in supine or right lateral decubitus position)

3. Grade 2 Clear Fluid (fluid only observed in both supine and right lateral decubitus position)

4. Solid

Secondary Outcome Measures
NameTimeMethod
Define the upper limit of normal fasting gastric volume defined as the 95th percentileLess than two hour prior to surgery

Define the upper limit of normal fasting gastric volume defined as the 95th percentile

Distribution of baseline gastric volume in fasted diabetic and non-diabetic patientsLess than two hour prior to surgery

Characterize the distribution of baseline gastric volume in fasted diabetic and non-diabetic patients

Duration and degree of glycemic control with baseline gastric fluid volume amongst diabetic patientsLess than two hour prior to surgery

To study the association between type of diabetes mellitus (I or II), duration and degree of glycemic control with baseline gastric fluid volume

Gastric volume of diabetic patients in relation with the medication/therapy used manage their diabetes.Less than two hour prior to surgery

To study the relationship between gastric volume in diabetic patients in relation with which medication and/or treatment they use to manage their diabetes. Examples of medication or treatment include; pharmaceutical hypoglycemics, insulin, or diet controlled.

Episodes of intra-operative regurgitation, vomiting or aspirationIntraoperative

Episodes of intra-operative regurgitation, vomiting or aspiration

Trial Locations

Locations (1)

Toronto Western Hospital

🇨🇦

Toronto, Ontario, Canada

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