Evidence map›Paper›PMID 37588578›Full record

ArticleBJA open2022

Impact of fasting on the gastric volume of critically ill patients before extubation: a prospective observational study using gastric ultrasound.

Stephen D O'Donoghue, Jason M Pincus, George K F Pang, Rebecca E Roach, Chris M Anstey, Anahi Perlas, André Van Zundert

Open access · goldAbstract read
In one paragraph

Article in BJA open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 37% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 2 countries.

Stephen D O'DonoghueDepartment of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Jason M PincusDepartment of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
George K F PangDepartment of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
Rebecca E RoachDepartment of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, VIC, Australia.
Chris M AnsteyGriffith University, Birtinya, QLD, Australia.
Anahi PerlasDepartment of Anaesthesia, Toronto Western Hospital, Toronto, ON, Canada.
André Van ZundertDepartment of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, Australia.
University of Queensland · AUGriffith University · AURoyal Brisbane and Women's Hospital · AUThe Alfred Hospital · AUToronto Western Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: A period of fasting before tracheal extubation of ventilated patients in the ICU is common practice, aiming to reduce gastric volume and aspiration risk. As the volume of gastric content is unknown at the time of extubation, the efficacy of this practice is uncertain. Methods: A prospective, observational study using gastric ultrasound was undertaken. Images were obtained at four time points: (i) at baseline, with gastric feeds running; (ii) after suctioning of gastric contents through a gastric tube; (iii) after a 4 h period with no gastric feed running; and (iv) after both a 4 h fasting period and gastric tube suctioning. The primary outcome was the proportion of patients classed as low risk of aspiration with each intervention, using qualitative and quantitative gastric ultrasound. Results: Fifty-four patients in the ICU were enrolled. Forty-four (81%) subjects had images that were suitable for analysis. Suctioning of stomach content through a gastric tube and fasting were equivalent with 39/44 (88.6%) and 5/44 (11.4%) subjects classified as low risk and at risk of aspiration, respectively. A period of fasting followed by suction resulted in 41/44 (93.2%) patients being at low risk. Conclusions: Suctioning of stomach contents through the gastric tube and a 4 h fasting period appear equivalent at reducing gastric volume below a safe threshold. A small percentage did not reach the threshold despite all interventions.

Indexed as

aspirationenteral feedextubationfastinggastric ultrasoundintensive care

Identifiers

PMID37588578
PMCPMC10430804
OpenAlexW4286202995

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.