Perioperative bronchoaspiration in a semaglutide user on a residue-free diet: a case report and insights from a complication
Bibliographic record
Abstract
INTRODUCTION: Perioperative bronchoaspiration is a serious complication often associated with inadequate fasting or delayed gastric emptying, including that caused by glucagon-like peptide-1 receptor agonists (GLP-1-RAs). Despite growing semaglutide use worldwide, evidence on the effectiveness of current preventive measures-such as residue-free diets-remains limited. CASE PRESENTATION: We report a 61-year-old female with obesity and chronic obstructive pulmonary disease who underwent elective coronary angiography. She had been using weekly semaglutide for weight loss, discontinued six days before the procedure, but did not disclose this during preoperative evaluation. Following institutional guidance, she adhered to a 24-h residue-free diet and 12-h fasting. A protocol breach led to omission of preoperative gastric ultrasound. During anesthesia induction, she experienced large-volume regurgitation requiring urgent airway management. Postoperative chest CT revealed aspiration-related inflammatory changes. She recovered uneventfully and later acknowledged omitting semaglutide use from her medical history because she did not consider it a "medication." CONCLUSION: This case demonstrates that even stricter dietary measures than those recommended in current guidelines may not eliminate aspiration risk in GLP-1-RA users. Active screening for GLP-1-RA use, consideration of extended discontinuation intervals, and routine bedside gastric ultrasound should be incorporated into perioperative protocols to enhance patient safety.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.005 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".