Relationship between the regurgitated and the aspirated volume of water. A manikin study

Lionel Bouvet; Eloïse Cercueil; Sophie Barnoud; Marc Lilot; François-Pierrick Desgranges; Dominique Chassard

doi:10.5114/ait.2019.85953

eISSN: 1731-2531
ISSN: 1642-5758

Anaesthesiology Intensive Therapy

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abstract:

Original article

Relationship between the regurgitated and the aspirated volume of water. A manikin study

Lionel Bouvet

^{1, 2, 3}

,

Eloïse Cercueil

¹

,

Sophie Barnoud

¹

,

Marc Lilot

¹

,

François-Pierrick Desgranges

^{1, 3}

,

Dominique Chassard

^{1, 2, 3}

Department of Anaesthesia and Intensive Care, Hospices Civils de Lyon, Femme Mère Enfant Hospital, Bron, France
University of Lyon, Claude Bernard Lyon 1 University, Villeurbanne, France
APCSe VetAgro Sup UPSP 2016.A101, Marcy l’Etoile, France

Anaesthesiol Intensive Ther 2019; 51, 2: 121–125

DOI: https://doi.org/10.5114/ait.2019.85953

Online publish date: 2019/06/16

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Background
The relationship between gastric fluid volume, volume of fluid regurgitated, and aspirated fluid volume remains unclear. Using a life-like manikin suitable for a pulmonary aspiration model, we aimed to assess the relationship between regurgitated and aspirated clear fluid volumes, and to determine the minimal value of the volume of liquid regurgitated that may lead to pulmonary aspiration of fluid volume ≥ 0.8 mL kg-1 (around 60 mL) that is likely to cause lung injury.

Methods
Several volumes of water ranging from 30 to 150 mL were injected in a randomized order, at a flow rate of 20 mL per second, into the esophagus of a manikin lying in the supine position on a non-tilted table, with the manikin head in the extension or in the sniffing position. Aspirated volumes were measured in the manikin bronchi, by an investigator blinded to the volume injected. Aspiration was defined as positive when the volume of collected water was ≥ 60 mL for at least one of the five injections of each volume of water.

Results
The minimal volume of water injected into the esophagus for an aspirated volume ≥ 0.8 mL kg-1 was 85 mL in the sniffing position, and was 150 mL in the extension position.

Conclusions
These results suggest that the critical cut-off value of gastric fluid volume to be considered for the risk of significant pulmonary aspiration would be ≥ 85 mL (≥ 1 mL kg-1), in the sniffing position. These results should however be confirmed in further studies using other models.

keywords:

Relationship between the regurgitated and the aspirated volume of water. A manikin study

Lionel Bouvet 1, 2, 3 , Eloïse Cercueil 1 , Sophie Barnoud 1 , Marc Lilot 1 , François-Pierrick Desgranges 1, 3 , Dominique Chassard 1, 2, 3

anesthesia, general, gastrointestinal contents, aspiration, manikin

Lionel Bouvet

^{1, 2, 3}

,

Eloïse Cercueil

¹

,

Sophie Barnoud

¹

,

Marc Lilot

¹

,

François-Pierrick Desgranges

^{1, 3}

,

Dominique Chassard

^{1, 2, 3}