J Korean Soc Emerg Med.  2022 Dec;33(6):532-542.

Multidetector computed tomography-based evaluation of gastric volumes in patients with out-of-hospital cardiac arrest

• Lee JJ
• Park HJ
• Yu GG
• Kim YM
• Kim SC
• Lee JH
• Chai HS
• Park GJ
• Lee SW
• Kim H

Abstract

Objective
Resuscitation-related gastric inflation is associated with inadequate ventilation and the risk of gastric regurgitation in out-of-hospital cardiac arrest (OHCA) patients. This study aims to estimate resuscitation-related gastric inflation values by using multi-detector computed tomography (MDCT) scanning.
Methods
MDCT imaging data were obtained from OHCA patients undergoing resuscitation from January 2014 to December 2020. Thirty age- and sex-matched healthy controls that underwent an MDCT scan were included. Gastric air volume (GAV), total gastric volume (TGV), and GAV/gastric content volume (GCV) ratio values were estimated.
Results
In healthy controls (n=30), GAV and TGV values were in the range 5.0-35.0 mL, and 202.0-1,002.0 mL, respectively. The mean GAV and TGV values of OHCA patients (n=97) were 251.0 mL (range, 55.5-896.0) and 878.0 mL (range, 430.5-1,696.0), respectively. Significant between-group differences were determined in the mean GCV, GAV, and GAV/GCV ratio values. In OHCA patients, the cut-off value for abnormal GAV was defined as 56.5 mL (mean value plus two times standard deviation). Patients with abnormal GAV findings on MDCT scans had a longer duration from arrest to the return of spontaneous circulation, low body mass index, and increased rates of lactic acidosis.
Conclusion
Our results indicate an association between gastric air accumulation after resuscitation with longer recovery from arrest to return of spontaneous circulation, low body mass index, and increased lactic acidosis.

Keyword

Resuscitation-related gastric inflation; out-of-hospital cardiac arrest; multi-detector computerized tomography; gastric air volume; total gastric volume