A comparison of the volume and pH of gastric contents of obese and lean surgical patients

Anesthesia and Analgesia
R L HarterR R Dzwonczyk

Abstract

Obese surgical patients are typically considered to be more likely than lean patients to possess high-volume and low-pH (HVLP) gastric contents after a standard preoperative fast, based on a study of a population predominately consisting of patients receiving intramuscular preoperative sedation. We revisited this issue in a study population of 256 fasted surgical patients, of which 232 received no preoperative antacid or gastric prokinetic drug. Immediately after endotracheal intubation, an 18-French sump tube was placed, and gastric contents were withdrawn. Subjects' gastric contents were defined as HVLP if they exhibited a combination of a volume > 25 mL and a pH < 2.5. Obesity was defined as a body mass index > 30. Among nonmedicated obese patients, the proportion with HVLP gastric contents was 20 of 75 (26.6%). The proportion of lean patients with HVLP gastric contents was 66 of 157 (42.0%). The difference between the HVLP proportions for these two groups was found to be significant (P < 0.05) using chi 2 analysis. Obesity seems to be associated with a significantly decreased risk of HVLP gastric contents among surgical patients with no history of gastroesophageal pathology after a normal interval of preoperative fasting. P...Continue Reading

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Citations

Sep 21, 2007·Obesity Surgery·Robson K IshidaIvan Cecconello
Apr 11, 2012·Obesity Surgery·Daniel P LemanuAndrew G Hill
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