Gastric Emptying of High Calorie Liquid Meals
Condition: Gastric Emptying
Study type: Interventional

Summary: 
      Perioperative fasting is an essential patient safety measure to reduce the risk of pulmonary
      aspiration of gastric contents, a rare but potentially catastrophic complication of
      anesthetic and airway management. Anesthesiologists' concern about aspiration and the
      increasing awareness towards the negative impact of prolonged restriction of oral intake have
      shaped the current fasting guidelines. However, due to the perceived safety of prolonged
      fasting and practical considerations, adoption of the fasting guidelines is suboptimal.

      Gastric ultrasound is a quick, non-invasive method to evaluate gastric contents and
      aspiration risk. Gastric ultrasound can accurately discriminate between solid particles and
      fluid content, and mathematical models can reliably predict the volume of the gastric
      contents from the gastric antral area (GAA).

      This project aims to use gastric ultrasound to provide new data that can support management
      strategies in perioperative patients, that ensure both a low aspiration risk and an adequate
      nutritional support.

      The investigators will test the hypothesis that commercially available liquid meals can be
      safely used preoperatively. A pilot crossover, study on healthy volunteers will be conducted
      to determine the gastric emptying time of high-calorie drinks, as compared to clear fluid.
    


Intervention name(s): Intervention #1: ProvideXtra Drink; Intervention #2: Fresubin Energy Drink; Intervention #3: Generic Glucose Solution
Intervention type(s): Dietary Supplement; Dietary Supplement; Dietary Supplement
Intervention description(s): Fasted subjects will be offered 200 ml of ProvideXtra and will be asked to ingest it at a comfortable rate. Subsequent gastric ultrasound examinations will be performed half-hourly (up to 6 hours) to determine the volume of the gastric contents. The intervention ends when the stomach appears to be empty again on ultrasound.; Fasted subjects will be offered 200 ml of Fresubin Energy Drink and will be asked to ingest it at a comfortable rate. Subsequent gastric ultrasound examinations will be performed half-hourly to determine the volume of the gastric contents. The intervention ends when the stomach appears to be empty again on ultrasound.; Fasted subjects will be offered the glucose solution and will be asked to ingest it at a comfortable rate. Subsequent gastric ultrasound examinations will be performed half-hourly (up to 6 hours) to determine the volume of the gastric contents. The intervention ends when the stomach appears to be empty again on ultrasound.
Other intervention name(s): fat-free, high-calorie drink containing hydrolised vegetal protein; high-calorie drink without fiber; Solution reconstituted form 75 g glucose and 300 ml water
Intervention MeSH terms: Pharmaceutical Solutions
Allocation: Randomized
Intervention model: Crossover Assignment
Intervention model description: 3 interventions will be administered in fasted healthy volunteers in a random sequence on 3 different days.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Other
Keywords: Preoperative fasting; Liquid meal; Gastric ultrasound