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Research Article
Gastric residual volumes and gastric ultrasound in young children fed with breast milk 3 hours prior to general anesthesia: A prospective observational study
1 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
2 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
3 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
4 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
5 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
6 Anaesthetic Department, Birmingham Women and Children’s (BWC) Hospital, Birmingham B15 2TG, UK
7 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
8 Anaesthetic Department, Birmingham Women and Children’s (BWC) Hospital, Birmingham B15 2TG, UK
9 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
10 Anaesthetic Department, King’s College Hospital (KCH), Denmark Hill, London SE5 9RS, UK
Address correspondence to:
Dominic Nielsen
Anaesthetic Department, King’s College Hospital, Denmark Hill, London SE5 9RS,
UK
Message to Corresponding Author
Article ID: 100022A05ES2025
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How to cite this article
Saffer E, Day S, Dukoff-Gordon A, Henderson D, Wing JLK, Rook W, Seddon DR, Stendall C, Ward C, Nielsen D. Gastric residual volumes and gastric ultrasound in young children fed with breast milk 3 hours prior to general anesthesia: A prospective observational study. Edorium J Anesth 2025;8(2):1–8.ABSTRACT
Aims: The volume of gastric contents that might be expected at anesthetic induction following a 3-hour breast milk fast has not yet been investigated. The role of gastric ultrasound in quantifying particulate gastric content is also undefined. The primary objective of this study is to assess the gastric residual volume (GRV) measured by gastric suctioning in children who are breast fed 3 hours prior to general anesthesia. The secondary objective is to compare measured and predicted GRV, using a published formula derived from a gastric ultrasound study in infants.
Method: An observational prospective study of children aged 37 weeks to 18 months, fed 3 hours prior to general anesthesia was performed at 2 tertiary pediatric centers. Assessment of gastric antrum was performed using gastric ultrasound. The correlation between predicted and measured gastric residual volume was investigated using Pearson’s correlation coefficient.
Results: Data from 44 general anesthetics performed in 42 children, with a median age of 9.5 months, and a median fasting time of 180 minutes are reported (range 150–210 minutes). Median GRV was 0 mL kg−1 (IQR 0–0.1). Correlation between predicted and actual gastric residual volume by aspiration was weak (r = 0.42, p = 0.007).
Conclusion: For breast milk fasting intervals of 3 hours, GRV was low and comparable to an overnight fast in this small study. The limited feasibility of performing awake gastric ultrasound in this age group, and therefore limitations as a clinical tool are discussed.
Keywords: Anesthesia, Breastfed, Fasting, Gastric
SUPPORTING INFORMATION
Author Contributions
Emily Saffer - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Stephanie Day - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Amy Dukoff-Gordon - Substantial contributions to conception and design, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Daniel Henderson - Acquisition of data, Drafting the article, Final approval of the version to be published
Julie Lau Kuen Wing - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
William Rook - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Dale R Seddon - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Catalina Stendall - Acquisition of data, Interpretation of data, Drafting the article, Final approval of the version to be published
Christopher Ward - Acquisition of data, Drafting the article, Final approval of the version to be published
Dominic Nielsen - Acquisition of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Emily Saffer et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
