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| Name | Class |
|---|---|
| Alberta Health services | OTHER |
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Given the pharmacodynamic and pharmacokinetic properties of glucagon-like peptide-1 (GLP-1) agonists, the Canadian Anesthesiologists' Society has recognized that patients on GLP-1 agonists may have an increased aspiration risk due to a 'full stomach,' even after following preoperative fasting guidelines. In other words, safe fasting timelines are not known in individuals taking GLP-1 agonists, as demonstrated by recent case reports of patients who either retained or regurgitated stomach contents despite being adequately fasted.
To address this gap, we plan to measure preoperative residual gastric volumes with point-of-care ultrasound (POCUS) in patients taking this medication. The priority is to first gather data to identify which patient populations need risk stratification and to then use this data to support the development of specific guidelines that reduce anesthetic complications, such as aspiration pneumonia.
Our primary objective is to use POCUS preoperatively to assess gastric volumes of fasted patients to demonstrate if there is a clinically significant increase in residual gastric volumes in patients on semaglutide.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| GLP-1 Agonist Group | Intervention: elective surgical patients taking GLP-1 receptor agonists |
| |
| Non GLP-1 Agonist Group | Intervention: elective surgical patients not taking GLP-1 receptor agonists |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| gastric antral sonography | Device | Participant will undergo gastric antrum ultrasound and be scanned in the supine position followed by the right lateral decubitus position. Qualitative and quantitative assessments will be completed. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants presenting with a full stomach | Full stomach defined as either clear fluid > 1.5ml/kg or solid content found with point-of-care gastric antral sonography. | Measured in the preoperative holding area |
| Measure | Description | Time Frame |
|---|---|---|
| Number of occurrences requiring change in anesthetic management plan | Changes in plan include those from laryngeal mask airway to more advanced endotracheal tube with rapid sequence induction and intubation or spinal anesthetic without sedation to administration of a general anesthetic. | From time of preoperative ultrasound in holding area to anesthesia induction in operating room |
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Inclusion Criteria:
Exclusion Criteria:
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Elective surgical patients meeting inclusion/exclusion criteria at the South Health Campus (Calgary, AB, Canada)
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| South Health Campus | Calgary | Alberta | T3M 1M4 | Canada |
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| Relationship between dose, duration and timing of GLP-1 receptor agonist and gastric volume | Explore if dose, duration, and timing of GLP-1 receptor agonist affects gastric volume | Measured in the preoperative holding area |
| Relationship between gastric emptying and purpose of GLP-1 receptor agonist administration | Explore if GLP-1 receptor agonist impacts gastric emptying different in patients administering for Type II diabetes mellitus or weight management | Measured in the preoperative holding area |