Emergency Surgery Clinical Trial
Official title:
Aspiration Risk Assessment by Gastric Ultrasound in eMErgency Surgery and ANesThetic Decision-making: a Multicentre Mixed Method Study- The ARGUMENT Study
NCT number | NCT06303492 |
Other study ID # | CTO 4096 |
Secondary ID | |
Status | Not yet recruiting |
Phase | N/A |
First received | |
Last updated | |
Start date | May 2024 |
Est. completion date | April 2026 |
Pulmonary aspiration of gastric contents is a serious patient safety problem accounting for 50% of anesthesia-related mortality. The risk is higher in patients undergoing emergency surgery as the gastric content is uncertain which poses a challenge to anesthetic decision-making. Standard clinical assessment to identify at-risk patients primarily relies on preoperative fasting guidelines and is not adequate for patients undergoing emergency surgeries. Point-of-care gastric ultrasound (GUS) has emerged as an accurate bedside tool providing information regarding the type and volume of gastric contents. When GUS was added to standard clinical assessment, anesthetic management plan changed in 71% of adult elective and 37% of pediatric emergency surgical procedures. Such data is lacking in adult patients undergoing emergency surgeries. The investigators propose a multicentre mixed-method study to evaluate the impact of GUS on aspiration risk assessment and subsequent Anesthetic Plan before emergency surgeries. The evidence from this study will improve patient safety by accurately identifying patients at risk of aspiration and tailoring anesthetic techniques and airway management to prevent pulmonary aspiration in patients undergoing emergency surgeries.
Status | Not yet recruiting |
Enrollment | 142 |
Est. completion date | April 2026 |
Est. primary completion date | December 2025 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Age >18 years - American Society of Anesthesiologists' (ASA) physical status I-III - Patients scheduled for non-elective non-cardiac surgery. Exclusion Criteria: - Abnormal anatomy of the upper gastro-intestinal tract (including hiatus hernia, gastric tumors, and previous surgeries of the upper gastrointestinal tract). - Extrinsic gastric compression obtained from the medical history or during the actual ultrasound examination. - Pregnancy. - Attending anesthesiologist refusal to include the patient for participation in the study |
Country | Name | City | State |
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n/a |
Lead Sponsor | Collaborator |
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Samuel Lunenfeld Research Institute, Mount Sinai Hospital |
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Proportion of change in Anesthetic Plan | The primary outcome of the study is a change from the initial anesthetic plan after viewing GUS results in the intervention group, and after being given the opportunity to revise the plan in the control group. | Baseline | |
Secondary | Percentage change in the three-category risk assessment before and after GUS | The secondary aim is only related to the intervention group, (1) to compare the aspiration risk assessment categories between the standard clinical assessment and GUS examination | Baseline |
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