Relationship between residual gastric content and peri‐operative semaglutide use assessed by gastric ultrasound: a prospective observational study
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Bibliographic record
Abstract
Summary Background Semaglutide is a long‐acting glucagon‐like peptide‐1 receptor agonist known to delay gastric emptying. Despite a growing body of evidence, its peri‐operative safety profile remains uncertain, particularly with regard to the risk of increased residual gastric content and aspiration of gastric contents during anaesthesia. We hypothesised that semaglutide interruption of ≤ 10 days before elective surgical procedures is insufficient to reduce or normalise the residual gastric content, despite fasting intervals that comply with current guidelines. Methods In this prospective observational study, we recruited patients who received pre‐operative once‐weekly subcutaneous semaglutide within 10 days of the procedure (semaglutide group) and control patients who had not been exposed to semaglutide (non‐semaglutide group). On the day of surgery, all patients underwent pre‐operative point‐of‐care gastric ultrasound to evaluate their residual gastric content. Increased residual gastric content was defined as any solid content or > 1.5 ml.kg ‐1 of clear fluids as assessed by gastric ultrasound. Results We recruited 220 patients, 107 in the semaglutide group and 113 in the non‐semaglutide group. Increased residual gastric content was found in 43/107 patients (40%) in the semaglutide group and 3/113 (3%) in the non‐semaglutide group (p < 0.001). In propensity‐weighted analysis, semaglutide use (OR 36.97, 95%CI 16.54–99.32), age (OR 0.95, 95%CI 0.93–0.98) and male sex (OR 2.28, 95%CI 1.29–4.06) were significantly associated with increased residual gastric content. There were no cases of pulmonary aspiration of gastric contents. Conclusion Pre‐operative semaglutide use within 10 days of elective surgical procedures was independently associated with increased risk of residual gastric content on pre‐operative gastric ultrasound assessment.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it