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Purpose of Review <p>Point-of-care gastric ultrasound (gastric POCUS) has provided clinicians with a tool for individualized aspiration risk assessment, moving beyond broad fasting guidelines and addressing the need for precise, bedside judgment in diverse surgical populations.</p> Recent Findings <p>Gastric POCUS utilizes a transducer probe to examine the gastric antrum in the supine, semirecumbent, or right lateral decubitus positions. The latter offers superior visualization of fluid volumes by allowing fluids to settle into the antrum of the stomach. The technique reliably distinguishes between empty, fluid-filled, and solid-filled stomachs. An empty antrum appears flat with hypoechoic layers, described as a “bullseye,” while solids may produce a heterogeneous hyperechoic “frosted-glass” pattern. Quantitative assessment via antral cross-sectional area has demonstrated high diagnostic accuracy, with a sensitivity of 100% and specificity of 97.5% for fluid volumes &gt; 1.5 mL/kg⁻¹. Implementing a right lateral decubitus antral cross-sectional area cutoff of 10.4&#xa0;cm² has produced results demonstrating similar utility.</p> Summary <p>Through bedside stratification of aspiration risk, gastric POCUS can impact perioperative management by guiding rapid sequence induction, determining when to delay procedures, and allowing for tailored anesthetic care. The findings of this review reveal that gastric POCUS has the potential to reduce the risk of unanticipated aspiration events and improve patient safety. </p>

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The Role of Gastric Ultrasound in Assessing Gastric Content and Aspiration Risk

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Kelly Gahagan,
  • Nina Sharifi,
  • Cameron Smith,
  • Meghan Brennan

摘要

Purpose of Review

Point-of-care gastric ultrasound (gastric POCUS) has provided clinicians with a tool for individualized aspiration risk assessment, moving beyond broad fasting guidelines and addressing the need for precise, bedside judgment in diverse surgical populations.

Recent Findings

Gastric POCUS utilizes a transducer probe to examine the gastric antrum in the supine, semirecumbent, or right lateral decubitus positions. The latter offers superior visualization of fluid volumes by allowing fluids to settle into the antrum of the stomach. The technique reliably distinguishes between empty, fluid-filled, and solid-filled stomachs. An empty antrum appears flat with hypoechoic layers, described as a “bullseye,” while solids may produce a heterogeneous hyperechoic “frosted-glass” pattern. Quantitative assessment via antral cross-sectional area has demonstrated high diagnostic accuracy, with a sensitivity of 100% and specificity of 97.5% for fluid volumes > 1.5 mL/kg⁻¹. Implementing a right lateral decubitus antral cross-sectional area cutoff of 10.4 cm² has produced results demonstrating similar utility.

Summary

Through bedside stratification of aspiration risk, gastric POCUS can impact perioperative management by guiding rapid sequence induction, determining when to delay procedures, and allowing for tailored anesthetic care. The findings of this review reveal that gastric POCUS has the potential to reduce the risk of unanticipated aspiration events and improve patient safety.