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J Korean Soc Emerg Med > Volume 33(6); 2022 > Article
Journal of The Korean Society of Emergency Medicine 2022;33(6): 532-542.
Multidetector computed tomography-based evaluation of gastric volumes in patients with out-of-hospital cardiac arrest
Jung-Ju Lee1 , Hyun-Jeong Park2 , Gyeong-Gyu Yu2 , Young-Min Kim1 , Sang-Chul Kim1,2 , Jee-Han Lee1 , Hyun-Seok Chai1 , Gwan-Jin Park1 , Suk-Woo Lee1,2 , Hoon Kim1,2
1Department of Emergency Medicine, Chungbuk National University Hospital, Cheongju, Korea
2Department of Emergency Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
Correspondence  Hoon Kim ,Tel: 043-261-2847, Fax: 043-269-7396, Email: nichekh2000@hanmail.net,
Received: February 7, 2022; Revised: March 7, 2022   Accepted: April 25, 2022.  Published online: December 31, 2022.
ABSTRACT
Objective:
Resuscitation-related gastric inflation is associated with inadequate ventilation and the risk of gastric regurgitation in out-of-hospital cardiac arrest (OHCA) patients. This study aims to estimate resuscitation-related gastric inflation values by using multi-detector computed tomography (MDCT) scanning.
Method:
MDCT imaging data were obtained from OHCA patients undergoing resuscitation from January 2014 to December 2020. Thirty age- and sex-matched healthy controls that underwent an MDCT scan were included. Gastric air volume (GAV), total gastric volume (TGV), and GAV/gastric content volume (GCV) ratio values were estimated.
Results:
In healthy controls (n=30), GAV and TGV values were in the range 5.0-35.0 mL, and 202.0-1,002.0 mL, respectively. The mean GAV and TGV values of OHCA patients (n=97) were 251.0 mL (range, 55.5-896.0) and 878.0 mL (range, 430.5-1,696.0), respectively. Significant between-group differences were determined in the mean GCV, GAV, and GAV/GCV ratio values. In OHCA patients, the cut-off value for abnormal GAV was defined as 56.5 mL (mean value plus two times standard deviation). Patients with abnormal GAV findings on MDCT scans had a longer duration from arrest to the return of spontaneous circulation, low body mass index, and increased rates of lactic acidosis.
Conclusion:
Our results indicate an association between gastric air accumulation after resuscitation with longer recovery from arrest to return of spontaneous circulation, low body mass index, and increased lactic acidosis.
Key words: Resuscitation-related gastric inflation; out-of-hospital cardiac arrest; multi-detector computerized tomography; gastric air volume; total gastric volume
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