Digestive diseases and sciences · 2025
Fasting Duration, Not Timing of Last GLP-1 Dose, Predicts Aspiration Risk Indicators: A Prospective Point-of-Care Gastric Ultrasound Study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Shahidifar Enayat, Lesniowska Marlena, Deschenes Ester, Polcha Gregory, Manzo Carl, Barreiro Timothy, Bigdeli Ghazaleh, Hemmat Arman, Brine Patrick, Malik Alexander, Song Gengqing
Аннотация
PURPOSE: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) delay gastric emptying, potentially increasing aspiration risk during anesthesia or sedation. Guidelines for withholding these agents before procedures remain inconsistent. This study prospectively evaluated whether prolonged fasting or time since the last GLP-1 RA dose more effectively predicts reduced solid gastric content and other indicators of aspiration risk.
METHODS: This prospective observational study enrolled 134 adults (74 GLP-1 RA users, 60 controls) from an internal medicine clinic, fasting 8-16 h. Point-of-care ultrasound (POCUS) was used to assess gastric antral content, cross-sectional area, and gastric volume (GV). Analyses included subgroup comparisons and multivariable regression adjusting for fasting duration, GLP-1 dose, and timing.
RESULTS: Solid gastric content was similar between GLP-1 users (4/74, 5.4%) and controls (3/60, 5.0%) (p = 0.563). Mean fasting duration was 13.0 ± 2.4 h. Among GLP-1 users, those with solids had shorter fasting times than those without (10.88 ± 0.75 vs. 13.14 ± 2.40 h; Welch's t-test p = 0.022, permutation p = 0.0684). Longer fasting trended toward lower odds of solids (OR = 0.61, p = 0.075). Fasting duration demonstrated a stronger inverse association with GV (β = - 2.26 mL/h) than time since last GLP-1 dose, which was not significant.
CONCLUSIONS: Fasting duration, rather than time since last GLP-1 dose, was more closely associated with reduced gastric content and volume. These findings support individualized fasting strategies and POCUS-based assessment over routine medication withholding for perioperative safety.
METHODS: This prospective observational study enrolled 134 adults (74 GLP-1 RA users, 60 controls) from an internal medicine clinic, fasting 8-16 h. Point-of-care ultrasound (POCUS) was used to assess gastric antral content, cross-sectional area, and gastric volume (GV). Analyses included subgroup comparisons and multivariable regression adjusting for fasting duration, GLP-1 dose, and timing.
RESULTS: Solid gastric content was similar between GLP-1 users (4/74, 5.4%) and controls (3/60, 5.0%) (p = 0.563). Mean fasting duration was 13.0 ± 2.4 h. Among GLP-1 users, those with solids had shorter fasting times than those without (10.88 ± 0.75 vs. 13.14 ± 2.40 h; Welch's t-test p = 0.022, permutation p = 0.0684). Longer fasting trended toward lower odds of solids (OR = 0.61, p = 0.075). Fasting duration demonstrated a stronger inverse association with GV (β = - 2.26 mL/h) than time since last GLP-1 dose, which was not significant.
CONCLUSIONS: Fasting duration, rather than time since last GLP-1 dose, was more closely associated with reduced gastric content and volume. These findings support individualized fasting strategies and POCUS-based assessment over routine medication withholding for perioperative safety.