Semaglutide May Increase Aspiration Risk During Surgery: New Study Investigates

Patients taking glucagon-like peptide-1 (GLP-1) agonists like Semaglutide may experience delayed gastric emptying, leading to a 'full stomach' even after following standard preoperative fasting guidelines. This poses a significant risk for pulmonary aspiration (inhaling stomach contents into the lungs) during anesthesia, which can cause severe complications like aspiration pneumonia. Recent case reports have highlighted instances where patients on GLP-1 agonists retained or regurgitated stomach contents despite adequate fasting, indicating that safe fasting timelines are currently unknown for this patient population.

As this study (NCT06263595) is currently recruiting and set to complete in July 2025, no specific findings or results are available yet. However, the researchers aim to quantitatively assess the impact of Semaglutide on gastric emptying by measuring preoperative residual gastric volumes using point-of-care ultrasound (POCUS). They hypothesize that patients on GLP-1 agonists will exhibit significantly higher residual gastric volumes compared to established norms for fasted individuals not on these medications. The primary objective is to identify a threshold, for instance, residual volumes exceeding 0.8 mL/kg, that indicates an elevated risk of pulmonary aspiration. This data will be crucial for comparing gastric emptying rates in Semaglutide users against non-users, aiming to quantify the increased risk and inform new clinical guidelines. The central goal is to gather robust data to determine if patients taking Semaglutide consistently retain stomach contents above safe thresholds, even after standard fasting protocols, thereby necessitating revised preoperative management.