Aspiration risk under anaesthesia: difference between revisions
Diff·revision 1 → 2·09:36, 18 Oct 2024
Difference between revision 1 and revision 2 of Aspiration risk under anaesthesia. 7 lines changed; the page grew by 1,029 bytes.
| Revision 1 — 03:23, 15 Oct 2024 PreregPriya (talk) start article; incidence figures to follow 1,230 bytes +1,230 | Revision 2 — 09:36, 18 Oct 2024 MTC_Marisol (talk) clarify that the rodent finding has not been observed in humans 2,259 bytes +1,029 | ||
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| 10 | The evidence is largely case reports and imaging series showing residual gastric contents on ultrasound after standard fasting in people taking these agents, rather than trials demonstrating an increased aspiration rate. Aspiration is rare enough that a randomised demonstration is impractical.{{r|joshi2023}} | 10 | The evidence is largely case reports and imaging series showing residual gastric contents on ultrasound after standard fasting in people taking these agents, rather than trials demonstrating an increased aspiration rate. Aspiration is rare enough that a randomised demonstration is impractical.{{r|joshi2023}} |
| 11 | 11 | ||
| + | 12 | == The mechanism and its magnitude == | |
| + | 13 | The gastric-emptying delay is largest during escalation and with short-acting agents, and attenuates with continued exposure to a long-acting agonist.{{r|marathe2013}} A person established on a weekly agent for months has a smaller delay than one in the first weeks of treatment.{{r|drucker2018}} | |
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| + | 15 | Gastric ultrasound can assess residual content directly and has been used both to demonstrate the phenomenon and, in practice, to guide individual decisions. It measures the thing of interest rather than a proxy, which is its advantage over any rule based on the drug alone.{{r|joshi2023}} | |
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| 12 | == References == | 17 | == References == |
| 13 | {{reflist}} | 18 | {{reflist}} |
| 14 | <ref name="joshi2023">Joshi GP, Abdelmalak BB, Weigel WA, et al. "American Society of Anesthesiologists consensus-based guidance on preoperative management of patients on glucagon-like peptide-1 receptor agonists." (2023).</ref> | 19 | <ref name="joshi2023">Joshi GP, Abdelmalak BB, Weigel WA, et al. "American Society of Anesthesiologists consensus-based guidance on preoperative management of patients on glucagon-like peptide-1 receptor agonists." (2023).</ref> |
| + | 20 | <ref name="drucker2018">Drucker DJ. "Mechanisms of action and therapeutic application of glucagon-like peptide-1." ''Cell Metabolism'' 27(4):740–756 (2018). PMID 29617641.</ref> | |
| + | 21 | <ref name="marathe2013">Marathe CS, Rayner CK, Jones KL, Horowitz M. "Relationships between gastric emptying, postprandial glycemia, and incretin hormones." ''Diabetes Care'' 36(5):1396–1405 (2013). PMID 23613599.</ref> | |
| 15 | 22 | ||
| 16 | {{DEFAULTSORT:Aspiration risk under anaesthesia}} | 23 | {{DEFAULTSORT:Aspiration risk under anaesthesia}} |