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array:24 [ "pii" => "S2341192919300083" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.08.015" "estado" => "S300" "fechaPublicacion" => "2019-02-01" "aid" => "965" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2019;66:72-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0034935618301476" "issn" => "00349356" "doi" => "10.1016/j.redar.2018.08.005" "estado" => "S300" "fechaPublicacion" => "2019-02-01" "aid" => "965" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Rev Esp Anestesiol Reanim. 2019;66:72-7" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 153 "formatos" => array:2 [ "HTML" => 97 "PDF" => 56 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">ORIGINAL</span>" "titulo" => "Evaluación radiológica del vaciamiento gástrico de medio de contraste hidrosoluble: nuevos datos de seguridad de un estudio longitudinal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "72" "paginaFinal" => "77" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Radiologic assessment of gastric emptying of water-soluble contrast media: New data security from a longitudinal study" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 4185 "Ancho" => 1500 "Tamanyo" => 275235 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Imágenes de rayos X representativas de un paciente con vaciamiento gástrico completo al término de la primera hora A), y de la segunda y tercera h, respectivamente B) y C).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.C. Niño, L.E. Ferrer, J.C. Díaz, D. Aguirre, S. Pabón, J.J. Pasternak" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M.C." "apellidos" => "Niño" ] 1 => array:2 [ "nombre" => "L.E." "apellidos" => "Ferrer" ] 2 => array:2 [ "nombre" => "J.C." "apellidos" => "Díaz" ] 3 => array:2 [ "nombre" => "D." "apellidos" => "Aguirre" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Pabón" ] 5 => array:2 [ "nombre" => "J.J." "apellidos" => "Pasternak" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192919300083" "doi" => "10.1016/j.redare.2018.08.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192919300083?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935618301476?idApp=UINPBA00004N" "url" => "/00349356/0000006600000002/v1_201901200630/S0034935618301476/v1_201901200630/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341192919300034" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.08.012" "estado" => "S300" "fechaPublicacion" => "2019-02-01" "aid" => "963" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2019;66:78-83" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Monitoring pulse pressure variation during lung resection surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "78" "paginaFinal" => "83" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Monitorización de la variación de la presión de pulso durante la cirugía de resección pulmonar" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1149 "Ancho" => 1582 "Tamanyo" => 74759 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">PPV variation at different measurement points. VPP_T1: lateral decubitus, bipulmonary ventilation (8<span class="elsevierStyleHsp" style=""></span>ml/kg), closed chest (prior to pulmonary collapse); VPP_T2: lateral decubitus, one-lung ventilation (6<span class="elsevierStyleHsp" style=""></span>ml/kg), open chest (minute 5); VPP_T3: lateral decubitus, one-lungventilation (6<span class="elsevierStyleHsp" style=""></span>ml/kg), open chest (immediately before restarting bipulmonary ventilation); VPP_T4: lateral decubitus, bipulmonary ventilation (8<span class="elsevierStyleHsp" style=""></span>ml/kg), closed thorax (minute 5).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Nieves Alonso, E. Alday Muñoz, A. Planas Roca" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Nieves Alonso" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Alday Muñoz" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Planas Roca" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935618301452" "doi" => "10.1016/j.redar.2018.08.003" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935618301452?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192919300034?idApp=UINPBA00004N" "url" => "/23411929/0000006600000002/v1_201902050605/S2341192919300034/v1_201902050605/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341192919300010" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.08.010" "estado" => "S300" "fechaPublicacion" => "2019-02-01" "aid" => "961" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2019;66:62-71" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Analgesic efficacy of modified pectoral block plus serratus plane block in breast augmentation surgery: A randomised, controlled, triple-blind clinical trial" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "62" "paginaFinal" => "71" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eficacia analgésica del bloqueo pectoral modificado más bloqueo del plano del serrato en mamoplastia subpectoral: ensayo clínico, controlado, aleatorizado, triple ciego" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 2229 "Ancho" => 2084 "Tamanyo" => 180295 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Box-plot showing verbal reporting scale (VRS) scores obtained at 3, 6 and 24 postoperative hours at rest and on passive and active movement of the extremity in each group. GC: control group; GPEC: treatment group.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.B. Schuitemaker R., X. Sala-Blanch, A.P. Sánchez Cohen, L.A. López-Pantaleon, J.T. Mayoral R., M. Cubero" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.B." "apellidos" => "Schuitemaker R." ] 1 => array:2 [ "nombre" => "X." "apellidos" => "Sala-Blanch" ] 2 => array:2 [ "nombre" => "A.P." "apellidos" => "Sánchez Cohen" ] 3 => array:2 [ "nombre" => "L.A." "apellidos" => "López-Pantaleon" ] 4 => array:2 [ "nombre" => "J.T." "apellidos" => "Mayoral R." ] 5 => array:2 [ "nombre" => "M." "apellidos" => "Cubero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935618301439" "doi" => "10.1016/j.redar.2018.08.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935618301439?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192919300010?idApp=UINPBA00004N" "url" => "/23411929/0000006600000002/v1_201902050605/S2341192919300010/v1_201902050605/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Radiologic assessment of gastric emptying of water-soluble contrast media: New data security from a longitudinal study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "72" "paginaFinal" => "77" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M.C. Niño, L.E. Ferrer, J.C. Díaz, D. Aguirre, S. Pabón, J.J. Pasternak" "autores" => array:6 [ 0 => array:4 [ "nombre" => "M.C." "apellidos" => "Niño" "email" => array:1 [ 0 => "mcnanesthesia@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L.E." "apellidos" => "Ferrer" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J.C." "apellidos" => "Díaz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "D." "apellidos" => "Aguirre" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "S." "apellidos" => "Pabón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "J.J." "apellidos" => "Pasternak" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Anestesia, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Facultad de Medicina, Universidad de los Andes, Bogotá, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Radiología, Hospital Universitario Santa Fe de Bogotá, Bogotá, Colombia" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Anestesiología, Mayo Clinic College of Medicine, Rochester, MN, United States" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Evaluación radiológica del vaciamiento gástrico de medio de contraste hidrosoluble: nuevos datos de seguridad de un estudio longitudinal" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 4185 "Ancho" => 1500 "Tamanyo" => 282222 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Representative radiograph of a patient with complete gastric emptying by the end of the first hour (A), and by the second and third hour, respectively (B) and (C).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Abdominal pain is the main cause of consultations in the emergency department in the 18–64-year age group, and is the third most common reason in the population older than 65 years.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a> Approximately 10% of visits to the emergency department are due to acute abdominal pain, impacting the quality of life and increasing the consumption of health care services.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The main methods used to investigate the need for surgery in these patients are physical examination, laboratory tests, abdominal ultrasound and computed tomography.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">3</span></a> Since its introduction in 1980, computed tomography has become a primary diagnostic tool in the study of abdominal pain in the emergency department.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Diagnosis based on physical examination and abdominal ultrasound correlates with the final diagnosis in 53–83% of cases. A lower sensitivity and specify has been reported for computed tomography. One of the limitations of ultrasound is inter-observer variability.<a class="elsevierStyleCrossRefs" href="#bib0140"><span class="elsevierStyleSup">2,5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Computed tomography is a widely used method to confirm suspicion of acute abdominal pain in the United States, with a use of 124% between 2001 and 2006 and 62 million CT scans performed annually to evaluate acute abdominal pain, many of which required oral administration of water-soluble contrast media (WSCM) to visualise the gastrointestinal tract.<a class="elsevierStyleCrossRefs" href="#bib0160"><span class="elsevierStyleSup">6–8</span></a> Both, clinical assessment and computed tomography identified an urgent cause in 89% of patients.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Occasionally, the findings on these examinations indicate the need of surgery in a patient with residual WSCM in the stomach, with the consequent risk of aspiration of the contrast media<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">9</span></a> or a delay in the final diagnosis, leading to unnecessary delays in patient management and disposition.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Thus, WSCM-enhanced CT creates a challenging environment for the anaesthesiologist. In clinical practise, decision makers must balance the need for timely surgery against the risk of possible complications due to incomplete gastric emptying<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a>. The 2017 American and European preoperative fasting guidelines help anaesthesiologists in their decision making, diminishing the risk of complications related to stomach contents.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">12,13</span></a> These include fasting recommendations ranging from 2<span class="elsevierStyleHsp" style=""></span>h for ingestion of clear liquids (water, pulpless juices, and carbonated beverages) to 6<span class="elsevierStyleHsp" style=""></span>h for ingestion of light meals.<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">14</span></a> However, there are no preoperative guidelines or studies on the use of WSCM and preoperative fasting time after intake.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The objective of this study, therefore, was to define gastric emptying after WSCM administration for abdominal CT scan in patients with acute abdominal pain who may require a surgery.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Materials and methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">Prior to the collection of data, approval was obtained from our hospital's research ethics committee (ref: CCEI-915-2010).</p><p id="par0045" class="elsevierStylePara elsevierViewall">This prospective longitudinal study was performed in patients aged over 18 years with acute abdominal pain, referred for contrast-enhanced abdominal CT scan from the Emergency Department. It was conducted over a period of 1 year.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Written informed consent was obtained prior to inclusion of each of the 75 patients included in the study. Exclusion criteria were pregnancy, signs and symptoms suggestive of intestinal obstruction, allergy to oral contrast medium, swallowing disorders, or refusal to participate in the study. Patients who received opioids or other medications that affects gastric motility were not excluded. Patients with pathologies that can alter gastric emptying, such as diabetes mellitus, neurological disease, collagen vascular disorders, viral infections, drugs were included.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Fasting time was grouped based on the American Society of Anaesthesiologists perioperative fasting guidelines.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Inter-observer variance also plays an important role in the measurement of gastric content. In this study, we aimed to reduce this difference as far as possible with the use of radiography.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Prior to data collection, a pilot test was performed to determine the barium concentration needed to provide adequate demarcation of the gastric chamber while avoiding the presence of artefacts on the CT scan. In 10 patients, a barium sulphate suspension (96%, w/w) was used, diluted to 5%, 10%, 15%, 20% and 25% (w/v) in 240<span class="elsevierStyleHsp" style=""></span>ml of water (2 for each concentration). Two trained radiologists determined that the 10% concentration was adequate for this purpose.</p><p id="par0070" class="elsevierStylePara elsevierViewall">WSCM was administered according to the institution's protocol to obtain adequate opacification of bowel loops. Exactly 250<span class="elsevierStyleHsp" style=""></span>ml of the 660<span class="elsevierStyleHsp" style=""></span>mg diatrizoate meglumine compound and 100<span class="elsevierStyleHsp" style=""></span>mg per millilitre of diatrizoate sodium (MD-Gastroview) were diluted in 1<span class="elsevierStyleHsp" style=""></span>l of water. Briefly, 250<span class="elsevierStyleHsp" style=""></span>ml of the diluted solution was administered orally to each patient every 15<span class="elsevierStyleHsp" style=""></span>min for 1<span class="elsevierStyleHsp" style=""></span>h, for a total of 4 doses. Two-hundred and forty ml of 10% (w/v) barium sulphate were administered orally to successfully obtain opacification of the gastric chamber 15<span class="elsevierStyleHsp" style=""></span>min after intake of the last diluted solution and immediately prior to the CT images. Abdomen and pelvis (from diaphragmatic dome to the pubic symphysis) were scanned with the protocol for low dose CT radiation (LightSpeed<span class="elsevierStyleSup">®</span>, VCT GE, Healthcare, Waukesha, Wisconsin, USA).</p><p id="par0075" class="elsevierStylePara elsevierViewall">The CT scan was taken to be time zero, and the first conventional erect abdominal radiograph was performed 1<span class="elsevierStyleHsp" style=""></span>h later, and repeated at 1-h intervals until no further significant barium opacification was seen in the stomach. A trained radiologist with more than 10 years’ experience in abdominal imaging reviewed each radiographic image. Complete gastric emptying was defined as no visualisation of barium in the stomach or the presence of minimal residual barium in gastric folds.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Quality standards for the radiograph studies were: correct identification of subject's medical record number, the time the image was acquired, adequate visualisation of the gastric chamber, and the inclusion of the appropriate anatomical structures such as hemi-diaphragms, the lower portion of the lung bases, and iliac crests.</p><p id="par0085" class="elsevierStylePara elsevierViewall">The primary outcome was gastric emptying time of WSCM as assessed by hourly simple abdominal radiographs. Demographic variables, factors influencing gastric emptying, and the patient's diagnosis were recorded. Immediate adverse events, such as allergy to contrast medium, arrhythmias, seizures, cardiogenic pulmonary oedema, and other events, such as allergic urticaria, bronchospasm, diffuse erythema with hypotension and anaphylactic shock were evaluated. To minimise bias, all data were collected by the same researcher.</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistics</span><p id="par0090" class="elsevierStylePara elsevierViewall">Patient characteristics were recorded in an Excel database. The statistical analysis was performed on STATA<span class="elsevierStyleSup">®</span> statistical software (StataCorp, College Station, TX, USA), version 12. Categorical variables were described using numbers and frequencies. Sample size was calculated on the assumption that 50% of the study population would present for gastric emptying between 2 and 4<span class="elsevierStyleHsp" style=""></span>h, with a power of 80%, confidence limit of 10% and confidence interval of 95%, which required a total of 70 patients.</p><p id="par0095" class="elsevierStylePara elsevierViewall">We used relative and absolute frequency measures for descriptive analysis of qualitative variables, and we analysed variables presumably associated with gastric emptying time. Fisher exact tests or Chi-squared tests were used to obtain the <span class="elsevierStyleItalic">P</span> value and explore correlations with our main outcome. To analyse inter-group correlations and differences, we calculated odds ratio with their respective 95% confidence intervals. A stratified analysis was performed, including pathologies and medications with effect on gastric emptying.</p></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">Seventy-five patients consented and were included in the study, but 7 patients withdrew from study; 68 patients completed the study.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Patient characteristics of are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Most had no significant comorbidities. The final diagnoses of these patients are also shown; acute appendicitis was the most prevalent reason for acute abdominal pain.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">After intake of the WSCM, 94.1% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>64) achieved complete gastric emptying within the first 3<span class="elsevierStyleHsp" style=""></span>h: 45.5% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>31) by the end of the first hour, 79.4% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>54) by the end of the second hour, and 94.1% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>64) by the end of the third hour. The remaining 5.9% (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>4) patients achieved complete gastric emptying of contrast within 6<span class="elsevierStyleHsp" style=""></span>h (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">As shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>, the rate of gastric emptying was not associated with co-morbidities, or with demographic or clinical characteristics.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a–c shows radiographs of different patients with complete gastric emptying by the end of the first, second and third hour, respectively.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Over the course of the study, none of the patients suffered any of the contrast-medium-induced adverse events described above.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0130" class="elsevierStylePara elsevierViewall">The time required to refer a patient to surgery after the ingestion of WSCM is a challenge for anaesthesiologists. This decision could be easier if preoperative guidelines included fasting recommendations after WSCM intake. However, there is currently no evidence for WSCM gastric emptying time.</p><p id="par0135" class="elsevierStylePara elsevierViewall">The data in this study show that 94.1% of the patients achieved complete gastric emptying within the first 3<span class="elsevierStyleHsp" style=""></span>h, with almost 80% achieving complete gastric emptying within the first 2<span class="elsevierStyleHsp" style=""></span>h. Fasting guidelines recommend 2<span class="elsevierStyleHsp" style=""></span>h of fasting for water, so assuming that WSCM has similar properties to water, we set the cut-off point at 2<span class="elsevierStyleHsp" style=""></span>h to determine the factors that, presumably, delayed gastric emptying time.</p><p id="par0140" class="elsevierStylePara elsevierViewall">It is thought that gastric motility depends on meal composition, comorbidities, and body mass index, among others.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">15</span></a> Interestingly, patient demographics and clinical characteristics did not seem to affect gastric emptying in our study.</p><p id="par0145" class="elsevierStylePara elsevierViewall">A meta-analysis of 49 published studies including 1457 subjects found that age had no impact on gastric emptying.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">16</span></a> Although the secretion of hydrochloric acid and pepsin are reduced under baseline conditions as a direct consequence of changes in cells and organs that secrete enzymes and hormones,<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">17</span></a> gastrointestinal transit time was similar in elderly and young patients.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">18</span></a> We found that although age<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>33 years could have an influence on gastric emptying, this was not statistically significant.</p><p id="par0150" class="elsevierStylePara elsevierViewall">Gender-related gastric emptying time is still controversial. While some authors have found similar gastric emptying rates in men and women,<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">19</span></a> others have found a significantly slower gastric emptying in women<a class="elsevierStyleCrossRefs" href="#bib0215"><span class="elsevierStyleSup">17,20</span></a> Apparently, the menstrual cycle influences gastric emptying, which is inhibited by estradiol and increased by progesterone.<a class="elsevierStyleCrossRefs" href="#bib0235"><span class="elsevierStyleSup">21,22</span></a> We found that sex did not significantly impact gastric clearance of WSCM.</p><p id="par0155" class="elsevierStylePara elsevierViewall">Studies evaluating the effect of body mass index (BMI) on gastric emptying are inconclusive due to the methodological inconsistencies found in earlier studies.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a> Increased BMI has been associated with a decrease, an increase, or no change in gastric.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> A study determining gastric emptying time by 13C breath tests found no association with BMI.<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a> Similarly, we found no association between BMI and gastric emptying time.</p><p id="par0160" class="elsevierStylePara elsevierViewall">Various comorbidities may have an influence on gastric emptying rate. Even though gastro-oesophageal reflux disease, non-insulin-dependent type II diabetes, acid-peptic disease, and hiatal hernia may slow down gastric emptying,<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a> they did not impact the gastric emptying rate of WSCM in our investigation. These comorbidities showed the greatest risk factor for an increased WSCM gastric emptying time, but were not statistically significant. However, due to our small sample size, robust conclusions regarding comorbidities cannot be made. The 2017 European guidelines for perioperative fasting acknowledge there is not enough evidence to confirm slower gastric emptying in this group of patients, and they should, therefore, be subject to the same fasting time as the healthy population.<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">7</span></a> These guidelines also indicate possible delayed gastric emptying in patients receiving opioids, but there is not enough evidence to make any specific recommendation. We found no significant relationship regarding the administration of opioids before surgery and gastric emptying time.</p><p id="par0165" class="elsevierStylePara elsevierViewall">The limitations of this study include its small study size, that could lead to over- or underestimation of the association between the covariates and gastric emptying. The fact that study subjects suffered from intra-abdominal pathologies that in themselves could influence gastric motility is an important limitation. We consider it very important to increase the sample size in future studies. The single-centre design of the study is also important. Patients with probable bowel obstruction were not included. Therefore, our findings cannot be extrapolated to all patients presenting to the emergency department with acute abdominal pain.</p><p id="par0170" class="elsevierStylePara elsevierViewall">Further investigation in a larger population is advised. Our study was limited to adults. We recommend that future studies include obstetric and paediatric populations.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="par0175" class="elsevierStylePara elsevierViewall">Our results show that 100% of patients with acute abdominal pain and no bowel obstruction achieved complete gastric emptying within 6<span class="elsevierStyleHsp" style=""></span>h after oral administration of WSCM. Nearly all (94.1%) achieved complete gastric emptying within 3<span class="elsevierStyleHsp" style=""></span>h, but 5.9% still showed evidence of WSCM in the stomach at 3<span class="elsevierStyleHsp" style=""></span>h. More studies are needed to determine the factors that delay gastric emptying of WSCM. Until then, we consider it is clinically relevant to wait 6<span class="elsevierStyleHsp" style=""></span>h after oral intake of the contrast media to ensure complete transit of WSCM through the stomach and avoid unnecessary risks.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Author's contributions</span><p id="par0180" class="elsevierStylePara elsevierViewall">C.N. This author conceived the study, helped with study design, data analysis, and manuscript approval. L.F. This author helped with study design, data analysis, and manuscript preparation and approved the final manuscript. D.A. This author helped with data collection and manuscript preparation. J.P. This author helped with the data acquisition and analysis, manuscript preparation and approval. S.P This author with manuscript preparation and approval. J.D. This author helped with data acquisition and analysis, and manuscript approval.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Conflicts of interests</span><p id="par0185" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interests.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1145555" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1075740" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1145554" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1075739" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Materials and methods" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Statistics" ] ] ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0035" "titulo" => "Author's contributions" ] 10 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of interests" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-04-12" "fechaAceptado" => "2018-08-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1075740" "palabras" => array:4 [ 0 => "Abdominal pain" 1 => "Contrast media" 2 => "Gastric emptying" 3 => "Fasting" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1075739" "palabras" => array:4 [ 0 => "Dolor abdominal" 1 => "Medio de contraste" 2 => "Vaciamiento gástrico" 3 => "Ayuno" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Practice guidelines for preoperative fasting have not clearly established the fasting time needed after oral administration of water-soluble contrast media. The aim of this study was to determine the time required for the gastric emptying during the water-soluble contrast media in patients with acute abdominal pain.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This prospective longitudinal study included sixty-eight patients older than 18 years of age with acute abdominal pain, who required a water-soluble contrast media enhanced abdominal computed tomography study. Plain radiographs were obtained hourly until complete the gastric emptying. Patients with probable bowel obstruction were not included in the study.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A total of 31 (45,6%), 54 (79,4%), and 64 (94.1%) patients achieved a complete gastric clearance of barium in 1, 2 and 3<span class="elsevierStyleHsp" style=""></span>h, respectively. All patients achieved complete emptying of water-soluble contrast media within 6<span class="elsevierStyleHsp" style=""></span>h. Gastric emptying time was not associated with gender (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.44), body mass index (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.35), fasting time prior to water-soluble contrast media intake (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.12), administration of opioids in the emergency room (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.7), and the presence of comorbidities (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.36).</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ninety-four percent of the patients with acute abdominal pain achieved complete gastric emptying within 3<span class="elsevierStyleHsp" style=""></span>h after the administration of water-soluble contrast media. All of them achieved complete gastric emptying within 6<span class="elsevierStyleHsp" style=""></span>h. The results suggested 6<span class="elsevierStyleHsp" style=""></span>h after oral intake of the contrast media is enough to complete transit of water-soluble contrast media through the stomach and avoid unnecessary risks.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusion" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Antecedentes y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En la actualidad, las guías de práctica clínica para ayuno preoperatorio no han establecido claramente el tiempo de espera necesario tras la administración de un medio de contraste hidrosoluble. Nuestro objetivo fue determinar el tiempo requerido para el vaciamiento gástrico posterior a la administración de un medio de contraste hidrosoluble en pacientes con abdomen agudo.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Materiales y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Este estudio longitudinal prospectivo incluyó 68 pacientes, mayores de 18 años, con abdomen agudo, a quienes se administró un medio de contraste hidrosoluble para la realización de una tomografía abdominal. Se obtuvieron radiografías cada hora hasta completar el vaciamiento gástrico del medio de contraste. Se excluyeron pacientes con sospecha de obstrucción intestinal.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Treinta y uno (45,6%), 54 (79,4%) y 64 (94,1%) pacientes alcanzaron la eliminación gástrica completa de bario en 1, 2 y 3 h, respectivamente. La totalidad de los pacientes alcanzó el vaciamiento gástrico completo dentro de las 6 primeras h. No se encontraron diferencias respecto al género (<span class="elsevierStyleItalic">P</span>=0,44), índice de masa corporal (<span class="elsevierStyleItalic">P</span>=0,35), tiempo de ayuno previo al contraste (<span class="elsevierStyleItalic">P</span>=0,12), administración de opioides en urgencias (P=0,7), ni presencia de comorbilidades (<span class="elsevierStyleItalic">P</span>=0,36).</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El 94% de los pacientes con abdomen agudo alcanzaron el vaciamiento gástrico completo dentro de las primeras 3 h posteriores a la administración de medio de contraste. A las 6 h, la totalidad de los participantes habían aclarado el medio de contraste. Consideramos relevante esperar las 6 h de ayuno posteriores a la ingesta oral del medio de contraste para asegurar el tránsito completo a través del estómago y evitar riesgos innecesarios.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Antecedentes y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Materiales y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Niño MC, Ferrer LE, Díaz JC, Aguirre D, Pabón S, Pasternak JJ. Evaluación radiológica del vaciamiento gástrico de medio de contraste hidrosoluble: nuevos datos de seguridad de un estudio longitudinal. Rev Esp Anestesiol Reanimac. 2019;66:72–77.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 4185 "Ancho" => 1500 "Tamanyo" => 282222 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Representative radiograph of a patient with complete gastric emptying by the end of the first hour (A), and by the second and third hour, respectively (B) and (C).</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristics \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span> (%) \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Gender</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40 (58.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28 (41.2) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Age (years)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">37.88 (13.97)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≤33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38 (55.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≥34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30 (44.1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Body mass index (kg</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">m</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">−2</span></span><span class="elsevierStyleItalic">)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.79 (3.86)<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≤24.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 (57.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≥25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (42.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Comorbidities</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>None \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 (70.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Gastro-oesophageal reflux \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">7 (10.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Peptic ulcer disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (20.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Others \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6 (8.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top">Fasting (hours)</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>≤8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29 (42.7) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>>8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39 (57.3) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Opioid analgesic in emergency room</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Yes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48 (70.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20 (29.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleItalic">Etiological diagnosis</span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute appendicitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25 (36.8) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Negative – pain resolved \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16 (23.5) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Irritable bowel syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4 (5.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Viral ileitis – infectious gastroenteritis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Acute diverticulitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5 (7.4) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mesenteric adenitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2 (2.9) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Other \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14 (20.6) \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1955079.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Mean (standard deviation).</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Distribution of patients with abdominal pain included in the study, by frequency.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Gastric emptying time (hour) \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>68 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">45.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">79.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">94.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">97.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">98.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="char" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1955081.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Number and percentage of patients with complete gastric emptying of WSCM by the end of each hour.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Characteristics \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">OR \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">95% CI \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Gender (male) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.10, 2.03 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.44 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Opioid administration in emergency room \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.69 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.37, 10.53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.70 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Age (≥34 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">1.35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.35, 5.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.84 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">BMI (≥25<span class="elsevierStyleHsp" style=""></span>kg<span class="elsevierStyleHsp" style=""></span>m<span class="elsevierStyleSup">−2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.54, 8.38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.35 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Perioperative fasting (>8<span class="elsevierStyleHsp" style=""></span>h) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.08, 1.29 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Comorbidities* \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.51, 8.47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">0.36 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1955080.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Correlation between patient characteristics and complete gastric emptying.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0135" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Abdominal pain: an approach to a challenging diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H.F. 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