Use of gastric ultrasound to identify GLP-1RA users at high risk of aspiration during surgery

The use of Glucagon Like Peptide-1 Receptor Agonists (GLP-1RAs) has been associated with delayed gastric emptying, which may result in patients scheduled for elective procedures presenting with increased gastric contents in the preoperative stage. Patients with shorter fasting periods, or increased gastric volume, present a concern for the anesthesiologist because of the danger of pulmonary aspiration, which carries a high risk of morbidity and mortality. The use of preoperative point of care (POC) gastric ultrasound (GUS) would be expected to identify patients with increased gastric contents thus requiring postponement or specific anesthetic management practices by an anesthesiologist in the perioperative setting. This article presents reasons for recommending 1) routine GUS for patients at risk to assess for increased gastric contents before elective surgical or endoscopic procedures and 2) specific anesthesia management practices when increased gastric contents are identified.