Feasibility of gastric point-of-care ultrasound (G-POCUS) to determine gastric content after gastrointestinal surgery: A prospective pilot study.

BACKGROUND: After gastrointestinal surgery, assessing gastric content provides insight in the recovery of gastrointestinal function. Gastric point-of-care ultrasound is a quick and noninvasive technique that enables objective bedside assessment of gastric content. This pilot study introduces gastric point-of-care ultrasound into routine postoperative care, evaluating the feasibility from nurses', patients', and quality perspectives. METHODS: Trained nurses performed gastric point-of-care ultrasound in patients after gastrointestinal surgery. Feasibility outcomes included nurses' perspectives on acceptability, measured with the theoretical framework of the acceptability questionnaire; nurses' self-confidence (questionnaire); usability measured with the Dutch-System Usability Scale; patients' perspectives on tolerance by measuring pain and comfort before, during, and after gastric point-of-care ultrasound; and quality perspectives, including gastric point-of-care ultrasound indications, technical success, length of a gastric point-of-care ultrasound assessment, accuracy, and qualitative (empty, fluids, and solids) and quantitative (volume of fluid) gastric point-of-care ultrasound results. RESULTS: A total of 52 gastric point-of-care ultrasound assessments were performed in 34 postoperative patients, mostly because of clinical signs of disturbed gastrointestinal function (n = 40, 81%), and mostly conclusive (n = 48, 92%). Reasons for nonconclusive gastric point-of-care ultrasound assessment included abdominal air, antrum not identified, or discomfort. Fluid content was found in 22 (46%) cases, with a median volume of 248 mL. Gastric point-of-care ultrasound was well accepted by nurses who also felt confident employing it. During the procedure, patients' pain and comfort levels did not change. The intraclass correlation coefficient for interpretation accuracy was 0.537, indicating moderate reliability. CONCLUSION: Ultrasound assessment of gastric content in patients recovering from major gastrointestinal surgery is feasible from nursing and patient perspectives. Examinations employed by nurses were successful, with acceptable inter-rater agreement in the interpretation.