ORIGINAL ARTICLE   Free access

Minerva Anestesiologica 2020 February;86(2):165-71

DOI: 10.23736/S0375-9393.19.13822-9

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Gastric emptying of “clear liquid drinks” assessed with gastric ultrasonography: a blinded, randomized pilot study

Sher-Lu PAI ✉, Elird BOJAXHI, Ilana I. LOGVINOV, Steven PORTER, Neil G. FEINGLASS, Christopher B. ROBARDS, Klaus D. TORP

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, USA

BACKGROUND: Protein-containing liquids may delay gastric emptying and increase risk of aspiration. Commercial whey protein nutritional drinks (WPNDs) are advertised as “clear liquid nutritional drinks” and can be mistaken for protein-free, carbohydrate-based clear liquids. We used gastric ultrasonography to compare gastric emptying of a protein-free, carbohydrate-based clear liquid with that of a WPND in healthy volunteers.
METHODS: We recruited 19 adult (age ≥18 years) volunteers with a body mass index less than 40 kg/m2 and without a history of diabetes mellitus, dysphagia, prior gastric surgery, or allergy to the ingredients of apple juice (AJ) or a WPND. After fasting for eight hours, the volunteers randomly received 474 mL of AJ or a WPND. Gastric ultrasonographic measurements were obtained at baseline and at 0, 30, 60, and 120 minutes after ingestion of the liquid.
RESULTS: We enrolled 19 volunteers. At 120 minutes after consumption, volunteers who ingested a WPND had a larger estimated gastric volume (GV) than volunteers who ingested AJ (median [interquartile range], 101.3 [70.0-137.4] vs. 50.6 [43.9-81.8] mL; P=.08). By using the 2-sample t test and an α level of .05, we determined that the study had 40% power to detect a significant difference in GV. Future studies need to include 24 participants per group to detect a significant difference.
CONCLUSIONS: Although consumption of a WPND was associated with a larger estimated GV in this pilot study, a larger study is necessary to conclude whether patients must fast longer than two hours after consumption of a WPND.

KEY WORDS: Gastric emptying; Perioperative medicine; Ultrasonography