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Gastric volume and pulmonary aspiration

Brock-Utne, J. G.*

European Journal of Anaesthesiology: April 2005 - Volume 22 - Issue 4 - p 321
doi: 10.1017/S0265021505270539

*Department of Anesthesia, Stanford University Medical Center, Stanford, CA, USA

Correspondence to: John G. Brock-Utne, Department of Anesthesia, Stanford University Medical Center, Stanford, CA 94305, USA. E-mail:; Tel: +1 650 723 6411; Fax: +1 650 725 8544

Accepted for publication October 2004


I have read with interest the article by Gouda and colleagues [1]. They refer to our work [2]. The conclusion to our paper was that the critical volume of gastric content in primates could be raised to 0.8 mL kg−1 at a pH of 1 not, as implied by the authors, a pH of 2.5. At a pH of 2.5, a much larger volume is now thought to be needed [Raidoo and colleagues 1993, unpublished results]. Since our studies [2,3] would seem to be the only large studies in primates, we believe that they are most likely more representative of what happens in humans than studies in rats, dogs, etc. It is of further interest that the Gouda and colleagues results are very like our own result with ranitidine in 1982 [4].

J. G. Brock-Utne

*Department of Anesthesia, Stanford University Medical Center, Stanford, CA, USA

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1. Gouda BB, Lydon AM, Badhe A, Shorten GD. A comparison of the effects of ranitidine and omeprazole on volume and pH of gastric contents in elective surgical patients. Eur J Anaesthesiol 2004; 21: 260-264.
2. Raidoo DM, Rocke DA, Brock-Utne JG, Marszalek A, Engelbrecht HE. Critical volume for pulmonary acid aspiration: reappraisal in a primate model. Br J Anaesth 1990; 65: 248-250.
3. Raidoo DM, Marzalek A, Brock-Utne JG. Acid aspiration in primates. A surprising experimental result. Anaesth Intensive Care 1988; 16: 375-376.
4. Andrews AD, Brock-Utne JG, Downing JW. Protection against pulmonary acid aspiration with ranitidine (a new histamine H2 receptor blocker). Anaesthesia 1982; 37: 22-25.
© 2005 European Society of Anaesthesiology