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Preoperative Gastric Ultrasound to Assess Stomach Contents and Aspiration Risk in Patients With Diabetes

Distribution of Residual Gastric Volume Assessed by Preoperative Gastric Ultrasound, Aspiration Risk, and Related Factors in Diabetic Patients Undergoing Elective Surgery: A Prospective Observational Study

Diabetes can slow down stomach emptying. As a result, some patients with diabetes may still have food or fluid in their stomach before surgery, even after following standard fasting rules. This can increase the risk of stomach contents entering the lungs (pulmonary aspiration) during anesthesia.

The aim of this prospective observational study is to measure the amount of residual stomach content using bedside gastric ultrasound in adult patients with type 1 or type 2 diabetes scheduled for elective surgery under general anesthesia. The study will also determine how often a high aspiration risk is present and identify clinical factors associated with it, including HbA1c level, duration of diabetes, use of GLP-1 receptor agonists, insulin use, fasting duration, and gastroparesis symptoms.

Gastric ultrasound is non-invasive, painless, and does not involve radiation. No drug or additional intervention will be given as part of this study. Patients found to be at high aspiration risk will be reported to the responsible anesthesiologist.

Přehled studie

Postavení

Zatím nenabíráme

Podmínky

Intervence / Léčba

Detailní popis

This is a prospective, observational, single-center study to be conducted at the University of Health Sciences Gazi Yasargil Training and Research Hospital. Approximately 130 adult patients (aged 18-80 years, ASA physical status I-III) with type 1 or type 2 diabetes mellitus scheduled for elective surgery under general anesthesia will be enrolled after written informed consent.

Each patient will be assessed at a single time point in the preoperative holding area before induction of anesthesia. Gastric ultrasound will be performed in the supine and right lateral decubitus positions. The anteroposterior and craniocaudal diameters of the gastric antrum will be measured, and the antral cross-sectional area (CSA) will be calculated. Gastric volume (GV) will be estimated using the Perlas formula [GV (mL) = 27 + 14.6 x CSA - 1.28 x age] and normalized to body weight (mL/kg). Gastric content will be classified according to the Perlas grading system (Grade 0-2). Patients with Perlas Grade 2 and/or GV >1.5 mL/kg will be classified as having high aspiration risk.

Demographic data, diabetes-related clinical parameters (type and duration of diabetes, HbA1c, fasting blood glucose, insulin and oral antidiabetic use), details of GLP-1 receptor agonist use (drug, dose, frequency, and time since last dose), preoperative fasting durations, and gastroparesis symptoms assessed with the Gastroparesis Cardinal Symptom Index (GCSI) will be recorded by a second investigator.

To minimize measurement bias, the ultrasound examination will be performed by a single trained anesthesiologist blinded to the patients' clinical data, while the investigator collecting clinical data will be blinded to the ultrasound findings.

Patients will be followed for 24-48 hours postoperatively through medical records for postoperative nausea and vomiting, fever, cough, dyspnea, pulmonary infiltrates on chest radiography, and clinical signs of aspiration pneumonia.

Factors associated with high aspiration risk will be analyzed using univariable and multivariable logistic regression. Correlations between gastric volume and HbA1c, diabetes duration, fasting duration, and GCSI score will be assessed using Pearson or Spearman correlation.

Typ studie

Pozorovací

Zápis (Odhadovaný)

130

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní kontakt

Studijní místa

    • Diyarbakır
      • Diyarbakır, Diyarbakır, Turecko (Türkiye), 21070
        • University of Health Sciences Gazi Yasargil Training and Research Hospital
        • Kontakt:

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

18 let až 80 let (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

Ne

Pohlaví způsobilá ke studiu

Všechno

Metoda odběru vzorků

Vzorek nepravděpodobnosti

Studijní populace

Adult patients with type 1 or type 2 diabetes mellitus scheduled for elective surgery under general anesthesia at the University of Health Sciences Gazi Yasargil Training and Research Hospital.

Popis

Inclusion Criteria:

  • Age 18-80 years
  • Diagnosis of type 1 or type 2 diabetes mellitus
  • Scheduled for elective surgery under general anesthesia
  • ASA physical status I-III
  • Written informed consent

Exclusion Criteria:

  • Emergency surgery
  • Pregnancy
  • History of upper gastrointestinal surgery
  • Known gastrointestinal obstruction
  • Known severe gastroparesis
  • Inadequate gastric ultrasound image quality
  • Refusal to provide consent

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Observační modely: COHORT
  • Časové perspektivy: PROSPECTIVE

Kohorty a intervence

Skupina / kohorta
Intervence / Léčba
Diabetic Patients Undergoing Elective Surgery

dult patients (18-80 years, ASA physical status I-III) with type 1 or type 2 diabetes mellitus scheduled for elective surgery under general anesthesia, who will undergo a single preoperative gastric ultrasound assessment and 24-48 hours of postoperative follow-up for clinical signs of aspiration.

Bedside gastric ultrasound performed in the supine and right lateral decubitus positions in the preoperative holding area before induction of anesthesia. The antral cross-sectional area will be measured, gastric volume will be calculated using the Perlas formula and normalized to body weight (mL/kg), and gastric content will be classified using the Perlas grading system. The examination is non-invasive and part of a single assessment; no drug or treatment is administered.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Residual Gastric Volume Assessed by Preoperative Gastric Ultrasound
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Gastric ultrasound will be performed in both the supine and right lateral decubitus positions. Gastric volume will be estimated from the antral cross-sectional area measured in the right lateral decubitus position using the Perlas formula [GV (mL) = 27 + 14.6 x CSA - 1.28 x age] and normalized to body weight (mL/kg). The distribution of residual gastric volume will be reported as mean, standard deviation, median, interquartile range, and minimum-maximum values.

Preoperatively, before induction of anesthesia (single assessment)

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Prevalence of High Aspiration Risk
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Proportion of patients classified as having high aspiration risk, defined as Perlas Grade 2 (fluid visible in both supine and right lateral decubitus positions) and/or gastric volume >1.5 mL/kg. Prevalence will be reported with 95% confidence interval

Preoperatively, before induction of anesthesia (single assessment)
Correlation Between HbA1c and Gastric Volume
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Correlation between preoperative HbA1c level (%) and weight-normalized gastric volume (mL/kg), assessed using Pearson or Spearman correlation coefficient.

Preoperatively, before induction of anesthesia (single assessment)
Correlation Between Diabetes Duration and Gastric Volume
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Correlation between duration of diabetes mellitus (years) and weight-normalized gastric volume (mL/kg), assessed using Pearson or Spearman correlation coefficient.

Preoperatively, before induction of anesthesia (single assessment)
Effect of GLP-1 Receptor Agonist Use and Timing of Last Dose on Gastric Volume
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Weight-normalized gastric volume (mL/kg) compared between GLP-1 receptor agonist users and non-users. Among users, gastric volume will be compared between patients whose last dose was taken ≤7 days and >7 days before the preoperative assessment

Preoperatively, before induction of anesthesia (single assessment)
Effect of Insulin Use on Gastric Volume
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Weight-normalized gastric volume (mL/kg) compared between patients using and not using insulin therapy.

Preoperatively, before induction of anesthesia (single assessment)
Correlation Between Preoperative Fasting Duration and Gastric Volume
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Correlation between preoperative solid and clear fluid fasting durations (hours) and weight-normalized gastric volume (mL/kg), assessed using Pearson or Spearman correlation coefficient.

Preoperatively, before induction of anesthesia (single assessment)
Correlation Between Gastroparesis Cardinal Symptom Index (GCSI) Score and Gastric Volume
Časové okno: Preoperatively, before induction of anesthesia (single assessment)

Correlation between total GCSI score (range 0-5, higher scores indicate more severe gastroparesis symptoms) and weight-normalized gastric volume (mL/kg), assessed using Pearson or Spearman correlation coefficient.

Preoperatively, before induction of anesthesia (single assessment)
Incidence of Postoperative Clinical Aspiration
Časové okno: Up to 48 hours after surgery

Number of patients developing clinical signs of pulmonary aspiration (fever, cough, dyspnea, new pulmonary infiltrate on chest radiography) or aspiration pneumonia, and postoperative nausea and vomiting, assessed from medical records.

Up to 48 hours after surgery

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Sponzor

Vyšetřovatelé

  • Vrchní vyšetřovatel: RENİM YÜKSEL, MD, University of Health Sciences, Gazi Yasargil Training and Research Hospital

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

15. prosince 2026

Primární dokončení (Odhadovaný)

30. června 2027

Dokončení studie (Odhadovaný)

30. června 2027

Termíny zápisu do studia

První předloženo

4. listopadu 2026

První předloženo, které splnilo kritéria kontroly kvality

4. listopadu 2026

První zveřejněno (Aktuální)

10. listopadu 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

10. listopadu 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

4. listopadu 2026

Naposledy ověřeno

1. listopadu 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • 441

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Popis plánu IPD

Individual participant data will not be shared due to patient confidentiality and data protection regulations. Aggregate results will be reported in the publication.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

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