P1051 - NURSE-PERFORMED GASTRIC ULTRASOUND (GUS) AFTER GASTROINTESTINAL SURGERY: PRELIMINARY RESULTS OF A FEASIBILITY STUDY

P1051

NURSE-PERFORMED GASTRIC ULTRASOUND (GUS) AFTER GASTROINTESTINAL SURGERY: PRELIMINARY RESULTS OF A FEASIBILITY STUDY

H. H. van Noort^1,*, M. C. Tacken², A. Posthuma¹, R. Jellema¹, M. Stommel³, G. Huisman-de Waal^1,4

¹Centre for Abdominal and Pelvine Care, ²Department of Anaesthesiology, ³Department of Surgery, ⁴Department of IQ Health, RadboudUMC, Nijmegen, Netherlands

Rationale: Gastrointestinal (GI) dysfunction is a burdensome complication after GI-surgery. Bedside assessment of gastric content with gastric ultrasound (GUS) might support decision-making regarding gastric decompression and nutritional therapy. This study aims to determine the feasibility of postoperative GUS performed by trained nurses.

Methods: In a prospective cohort study, GUS was performed on the ward in patients recovering from major GI surgery. Feasibility was defined as technical success and acceptable patient tolerance. GUS was technically successful in case images of the antrum and landmarks were obtained and type of gastric content could be interpreted. Patient tolerance involved pain and comfort scores assessed before, in supine and right lateral decubitus (RLD) position, and after GUS on a NRS scale 0-10.

Results: 44 GUS assessments were performed in 21 patients. Patients, 61 (SD 12) years old, recovered from pancreatic (n=5), colorectal (n=10), liver (n=2) and HIPEC (n=4) surgery. GUS was not successful due to abdominal air (n=5), pain (n=2), or other reasons (n=2) hindering image acquisitions, and 2 non-interpretable GUS images. Interpreation of the 33 (75%) successful GUS assessments found that the gastric antrum was empty (n=12), filled with fluids (n=19) or solids (n=2). Mean gastric volume, estimated in 16/19 (84%) cases, was 320ml (SD 260). GUS images were made during GI dysfunction (19/33) and nasogastric tubes (NGT's) (11/33) cases. NGTs were placed in 7/33 cases after GUS. Patient’s tolerance was adequate, without elevation of pain, although comfort was lower in RLD position (-1.3 (95%CI -0.1- -1.6), p=0.038).

Conclusion: Nurse-performed gastric ultrasound is feasible in most postoperative patients. GUS should be cautiously integrated in postoperative decision making on gastric decompression with attention for patients’ comfort during GUS.

Disclosure of Interest: None declared