Gastric ultrasound in patients receiving semaglutide: a prospective, multicentre, matched control study.
Level 3 - non-randomized controlled study
Prospective non-randomised matched cohort study with concurrent controls
PubMed 41631344 · doi:10.1111/anae.70129
What was done
In a prospective multicentre study, researchers evaluated 44 patients receiving semaglutide for diabetes or weight loss who were undergoing elective surgery, alongside 44 controls matched 1:1 for age, BMI, and diabetes mellitus status. Patients underwent preoperative gastric ultrasound in both the supine and right lateral decubitus positions. A 'full stomach' was defined as visible solid gastric content in any position or a calculated gastric volume exceeding 1.5 ml.kg⁻¹ of total body weight in the right lateral decubitus position.
What was found
A full stomach was identified in 21/43 (49%) of patients taking semaglutide compared with 8/44 (18%) of controls (odds ratio 4.29, 95% CI 1.63–11.29, p = 0.003). Solid gastric contents were present in 18/43 (42%) of patients taking semaglutide compared with 3/44 (7%) of controls (odds ratio 9.85, 95% CI 2.57–37.76, p < 0.001). Calculated gastric volume did not differ significantly between groups.
Why it matters
This study shows that residual gastric content, particularly solid food, remains significantly elevated in patients receiving semaglutide even after withholding one dose and matching for key confounders like diabetes, age, and BMI. It supports using point-of-care gastric ultrasound to guide individualised aspiration risk management.
Limits
The sample size is small (n = 88 total enrolled, 87 analyzed), leading to wide confidence intervals for effect estimates. The study evaluated surrogate ultrasound metrics rather than clinical pulmonary aspiration events, and specific fasting durations are not reported in the abstract.
Cited by
- supports Patients on semaglutide undergoing general anesthesia have been found to retain food in their stomach despite fasting for 24 hours.