Obesity may present challenges but does not preclude gastric ultrasound
Notice bibliographique
Résumé
We thank Yarımoglu et al. [1] for their valuable comments regarding our recently published work [2]. As noted in our methods, we had initially not included patients with BMI > 40 kg.m-2 and ASA physical status score ≥ 3 [2]. However, and as rightfully pointed out by Yarımoglu et al. [1], the data in table 1 indicate that the upper range limit of BMI was 46.4 kg.m-2 in the semaglutide group and 40.1 kg.m-2 in the non-semaglutide group [2]. Upon reviewing our data, we identified four patients with morbid obesity (BMI 40.7, 42.4, 45.1 and 46.4 kg.m-2) in the semaglutide group and one (BMI 40.1 kg.m-2) in the non-semaglutide group [2]. While we apologise for this oversight, on further review of our data, neither of these patients had increased residual gastric content upon point-of-care gastric ultrasound assessment. As per our institutional protocol, all patients (regardless of BMI) who had used semaglutide within 10 days of their elective surgical procedure underwent pre-operative bedside gastric ultrasound to mitigate the risk of bronchoaspiration which explains the inclusion of patients with morbid obesity in our dataset. In the non-semaglutide group, patients were recruited from a convenience sample of those presenting for elective procedures under anaesthesia, according to the institutional elective surgical scheduling. Given logistical constraints, it was impractical to perform gastric ultrasound in all patients during the data collection period. Importantly, despite our unintentional inclusion (in both groups) of five patients with BMI > 40 kg.m-2, the conclusions of our study remain unchanged [2]. Even with the original analysis using propensity score, no statistical difference in residual gastric content was observed related to obesity, which aligns with existing published data [3]. Our findings suggest that semaglutide use and patient age (but not BMI) were the key determinants of increased residual gastric content in our studied population. It is important to note that our studied groups were not initially matched for age, weight, BMI or sex, as the convenience sampling of non-semaglutide users remains a recognised limitation [2]. Finally, our primary reason for excluding patients with BMI > 40 kg.m-2 was the potential technical challenges in performing gastric ultrasound in this patient population, which could lead to inconclusive results. Nevertheless, several studies have shown the feasibility and validity of point-of-care gastric ultrasound to assess residual gastric content in patients with BMI > 40 kg.m-2 [4, 5]. It is important to note that all bedside gastric ultrasound assessments in our study were performed by trained/experienced professionals, thereby significantly reducing, albeit not eliminating, the potential for interpretation bias.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».