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. 2018 Jan 12;18(1):6.
doi: 10.1186/s12871-018-0470-3.

The predictive value of hunger score on gastric evacuation after oral intake of carbohydrate solution

Qiu Weiji  1 , Li Shitong  2 , Luo Yu  3 , Hua Tianfang  4 , Kong Ning  4 , Zhang Lina  5
Affiliations

The predictive value of hunger score on gastric evacuation after oral intake of carbohydrate solution

Qiu Weiji et al. BMC Anesthesiol. .

Abstract

Background: Surgical patients are asked to fast for a sufficient duration to ensure that the amount of residual liquid in the stomach is within the safe range, thereby reducing the risk of gastric reflux perioperatively. The authors hypothesized that subjective hunger numerical rating scale (NRS) score could also help assess the process of gastric emptying and determine the amount of fluid remaining in the stomach.

Methods: The current study consisted of healthy volunteers recruited by advertisement and mutual introduction. Participants were asked to rate their subjective hunger feeling every 30 min after oral administration of 8 mL/kg carbohydrate nutrient solution that contained 10% maltodextrin and 2.5% sucrose. Consecutively, the gastric residual fluid was measured by magnetic resonance imagining (MRI). The Spearman's correlation coefficient, the ROC curves and the stepwise regression were used to analyze the predictive value of NRS for the gastric emptying process.

Results: The cohort consisted of 29 healthy volunteers enrolled in this study. The area under ROC curves estimated by the NRS score for the gastric residual volume of 2 mL/kg, 1 mL/kg, and 0.5 mL/kg were AUC2.0 = 0.78, AUC1.0 = 0.76, and AUC0.5 = 0.72, respectively. The correlation coefficient between the NRS score and the residual liquid in the stomach was -0.57 (P < 0.01). The correlation coefficient between the increase of the NRS score and the decrease of gastric liquid residual volume was 0.46 (P < 0.01). The standardized estimate of NRS score for the residual volume was -0.18 (P < 0.01) and the standardized estimate of fasting time was -0.73 (P < 0.01).

Conclusions: The subjective hunger NRS score can not accurately predict the gastric residual volume, but it can provide a reference for clinicians to judge the gastric emptying process and it should be used as a second check after oral intake of clear fluids before surgery according to the new fasting protocol.

Keywords: ERAS; Gastric emptying; Gastric residual volume; Magnetic resonance imaging; Numerical rating scale; Preoperative fasting; Subjective hunger feeling.

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Conflict of interest statement

Ethics approval and consent to participate

This prospective study was approved by the Ethics and Research Committee of the Shanghai Fourth People’s Hospital, (number 2015001, Shanghai China). Written informed consent was obtained from all the participants enrolled in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The participant underwent five serial epigastric MRI scans. The volume of fluid in the stomach was circled and calculated by AW suit software (GE company, USA) at the fasting state, 30 min, 60 min, 90 min, and 120 min after drinking carbohydrate solution separately (a–e)
Fig. 2
Fig. 2
Area under the ROC Curve for the Gastric Residual Volume. a Area under the ROC Curve for Gastric Residual Volume (2 mL/kg), AUC2.0 = 0.78. b Area under the ROC Curve for Gastric Residual Volume (1 mL/kg), AUC1.0 = 0.76. c Area under the ROC Curve for Gastric Residual Volume (0.5 mL/kg), AUC0.5 = 0.72
See this image and copyright information in PMC

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