Ultrasound assessment of gastric content and volume in liver transplant recipients

Aim: The aim of this study was to evaluate gastric content and volume by preoperative USG in elective liver transplant recipients who have reached adequate fasting times. Material and Method: Gastric content and volume of 64 patients who had a fasting period of at least 8 hours before elective surgery were scaned with USG. Following the qualitative evaluation, antral CSA was measured in patients and GRV was calculated using mathematical formulas. Antral CSA cutoff value for the diagnosis of stomach fullness risk was adopted as >340 mm2. The mean, standard deviation, median, frequency, and percentage were used to describe the data set; Spearman's rho test was used to make inferences statistics. Results: As a result of the qualitative evaluation, it was determined that the gastric antrums of the 20 patients were empty 31,3%, 12 of them was liquid with particles (18,8%) and 32 of them were solid (50%). According to the cutoff value of 340 mm2 (1183,73±451,99) determined for the diagnosis of stomach fullness risk, an increased rate was determined in 67,2% of patients. Moreover, among patients, both antral CSA and GRV were positively corelated with ascites in the abdomen, nasogastric liquid in the first hour of the operation, nasogastric liquid at the end of the operation, Child-Pugh score and MELD-Na score. Conclusion: In the current study, it was concluded that the use of USG is a non-invasive imaging tool that can guide anesthesia management in liver transplant recipients who have risk of gastric filling despite recommended fasting protocols. In liver transplant recipients, ascites in the abdomen, Child-Pugh score and MELD-Na score can be guides in choosing the anesthesia method by determining the risk of perioperative aspiration.