Gastric ultrasound performance time and difficulty: a prospective observational study

Area of Science:

• Peri-operative Medicine
• Medical Imaging
• Ultrasound Technology

Background:

• Point-of-care gastric ultrasound is an emerging technique in peri-operative care.
• Limited data exist on the technical challenges and training requirements for gastric ultrasound.
• Understanding these challenges is essential for optimizing physician training and improving patient safety.

Purpose of the Study:

• To analyze factors associated with technical difficulty and prolonged performance time in gastric ultrasound examinations.
• To identify patient characteristics and surgical factors that complicate gastric ultrasound procedures.
• To inform the development of targeted training programs for physicians performing gastric ultrasound.

Main Methods:

• Prospective observational study analyzing 2003 gastric ultrasound scans performed by 73 physicians.
• Physicians received structured training, performing at least 30 supervised scans before independent practice.
• Regression models identified factors associated with deviation from the sonography algorithm, performance time, and scan difficulty.

Main Results:

• A median performance time of 5 minutes was achieved after 20-27 scans.
• Increased BMI, male sex, trauma surgery, higher ASA physical status (3 or 4), and emergency surgery were associated with increased difficulty and duration.
• Male sex (OR 3.31) and trauma surgery (OR 3.26) significantly increased difficulty and deviation from the algorithm.

Conclusions:

• Around 50 gastric ultrasound scans are required to achieve a baseline performance time of 5 minutes.
• Future training should emphasize challenging patient groups: those with obesity, male patients, higher ASA status, and trauma cases.
• Targeted training can improve proficiency and reduce technical challenges in point-of-care gastric ultrasound.