Association of glucagon-like peptide receptor 1 agonist therapy with the presence of gastric contents in fasting patients undergoing endoscopy under anesthesia care : a historical cohort study
© 2024. Canadian Anesthesiologists' Society..
PURPOSE: We aimed to estimate the association of glucagon-like peptide 1 (GLP-1) receptor agonist therapy with the incidence of endoscopically visible gastric contents after preprocedural fasting.
METHODS: We reviewed the records of esophagogastroduodenoscopy (EGD) performed at our institution between 2019 and 2023 and determined the presence of residual gastric contents from the procedure notes and saved images. We compared patients taking GLP-1 agonists at the time of the procedure (GLP group, 90 procedures) with patients who started GLP-1 agonist therapy within 1,000 days after undergoing EGD (control, 102 procedures). We excluded emergent procedures without fasting, combined EGD/colonoscopy procedures, and patients with known gastroparesis or previous gastric surgery. We estimated the association between GLP-1 agonist therapy and residual gastric contents with a confounder-adjusted generalized linear mixed effect model.
RESULTS: Compared with controls, the GLP cohort had a higher age, American Society of Anesthesiologists' Physical Status, and incidence of nausea and diabetes mellitus. Body mass index and fasting duration were comparable between groups. Visible gastric content was documented in 17 procedures in the GLP group (19%) and in five procedures in the control group (5%), with an associated confounder adjusted odds ratio of 5.8 (95% confidence interval, 1.7 to 19.3; P = 0.004). There were five instances of emergent endotracheal intubation in the GLP group vs one case in control and one case of pulmonary aspiration vs none in control.
CONCLUSIONS: In fasting patients, GLP-1 agonist therapy was associated with an increased incidence of residual gastric contents, potentially posing an additional risk of periprocedural pulmonary aspiration.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
Canadian journal of anaesthesia = Journal canadien d'anesthesie - (2024) vom: 14. März |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Association d’un traitement par agonistes des récepteurs du peptide-1 de type glucagon avec la présence de contenu gastrique chez des personnes à jeun bénéficiant d’une endoscopie sous anesthésie : une étude de cohorte historique |
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| Beteiligte Personen: |
Wu, Fei [VerfasserIn] |
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| Links: |
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| Themen: |
Complications |
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| Anmerkungen: |
Date Revised 15.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s12630-024-02719-z |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369755219 |
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| 100 | 1 | |a Wu, Fei |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association of glucagon-like peptide receptor 1 agonist therapy with the presence of gastric contents in fasting patients undergoing endoscopy under anesthesia care |b a historical cohort study |
| 246 | 3 | 3 | |a Association d’un traitement par agonistes des récepteurs du peptide-1 de type glucagon avec la présence de contenu gastrique chez des personnes à jeun bénéficiant d’une endoscopie sous anesthésie : une étude de cohorte historique |
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| 500 | |a Date Revised 15.03.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © 2024. Canadian Anesthesiologists' Society. | ||
| 520 | |a PURPOSE: We aimed to estimate the association of glucagon-like peptide 1 (GLP-1) receptor agonist therapy with the incidence of endoscopically visible gastric contents after preprocedural fasting | ||
| 520 | |a METHODS: We reviewed the records of esophagogastroduodenoscopy (EGD) performed at our institution between 2019 and 2023 and determined the presence of residual gastric contents from the procedure notes and saved images. We compared patients taking GLP-1 agonists at the time of the procedure (GLP group, 90 procedures) with patients who started GLP-1 agonist therapy within 1,000 days after undergoing EGD (control, 102 procedures). We excluded emergent procedures without fasting, combined EGD/colonoscopy procedures, and patients with known gastroparesis or previous gastric surgery. We estimated the association between GLP-1 agonist therapy and residual gastric contents with a confounder-adjusted generalized linear mixed effect model | ||
| 520 | |a RESULTS: Compared with controls, the GLP cohort had a higher age, American Society of Anesthesiologists' Physical Status, and incidence of nausea and diabetes mellitus. Body mass index and fasting duration were comparable between groups. Visible gastric content was documented in 17 procedures in the GLP group (19%) and in five procedures in the control group (5%), with an associated confounder adjusted odds ratio of 5.8 (95% confidence interval, 1.7 to 19.3; P = 0.004). There were five instances of emergent endotracheal intubation in the GLP group vs one case in control and one case of pulmonary aspiration vs none in control | ||
| 520 | |a CONCLUSIONS: In fasting patients, GLP-1 agonist therapy was associated with an increased incidence of residual gastric contents, potentially posing an additional risk of periprocedural pulmonary aspiration | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a complications | |
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| 650 | 4 | |a full stomach | |
| 650 | 4 | |a liraglutide | |
| 650 | 4 | |a morbidity | |
| 650 | 4 | |a mortality | |
| 650 | 4 | |a pulmonary aspiration | |
| 650 | 4 | |a rapid sequence intubation | |
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| 700 | 1 | |a Smith, Matthew R |e verfasserin |4 aut | |
| 700 | 1 | |a Mueller, Ariel L |e verfasserin |4 aut | |
| 700 | 1 | |a Klapman, Seth A |e verfasserin |4 aut | |
| 700 | 1 | |a Everett, Lucinda L |e verfasserin |4 aut | |
| 700 | 1 | |a Houle, Timothy |e verfasserin |4 aut | |
| 700 | 1 | |a Kuo, Braden |e verfasserin |4 aut | |
| 700 | 1 | |a Hobai, Ion A |e verfasserin |4 aut | |
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