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KMID : 0385920220330060532
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Journal of the Korean Society of Emergency Medicine
2022 Volume.33 No. 6 p.532 ~ p.542
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Analysis of reasons for Multidetector computed tomography-based evaluation of gastric volumes in patients with out-of-hospital cardiac arrest
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Lee Jung-Ju
Park Hyun-Jeong
Yu Gyeong-Gyu
Kim Young-Min
Kim Sang-Chul
Chai Hyun-Seok
Park Gwan-Jin
Lee Suk-Woo
Kim Hoon
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Abstract
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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.
Method: 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.
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KEYWORD
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Resuscitation-related gastric inflation, out-of-hospital cardiac arrest, multi-detector computerized tomography, gastric air volume, total gastric volume
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