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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.

調査の概要

状態

まだ募集していません

条件

介入・治療

詳細な説明

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.

研究の種類

観察的

入学 (推定)

130

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

研究場所

    • Diyarbakır
      • Diyarbakır、Diyarbakır、トルコ(Türkiye)、21070
        • University of Health Sciences Gazi Yasargil Training and Research Hospital
        • コンタクト:

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

18年~80年 (大人、高齢者)

健康ボランティアの受け入れ

いいえ

受講資格のある性別

全て

サンプリング方法

非確率サンプル

調査対象母集団

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.

説明

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

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 観測モデル:COHORT
  • 時間の展望:PROSPECTIVE

コホートと介入

グループ/コホート
介入・治療
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.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Residual Gastric Volume Assessed by Preoperative Gastric Ultrasound
時間枠: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)

二次結果の測定

結果測定
メジャーの説明
時間枠
Prevalence of High Aspiration Risk
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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
時間枠: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

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

捜査官

  • 主任研究者:RENİM YÜKSEL, MD、University of Health Sciences, Gazi Yasargil Training and Research Hospital

出版物と役立つリンク

研究に関する情報を入力する責任者は、自発的にこれらの出版物を提供します。これらは、研究に関連するあらゆるものに関するものである可能性があります。

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年12月15日

一次修了 (推定)

2027年6月30日

研究の完了 (推定)

2027年6月30日

試験登録日

最初に提出

2026年11月4日

QC基準を満たした最初の提出物

2026年11月4日

最初の投稿 (実際)

2026年11月10日

学習記録の更新

投稿された最後の更新 (実際)

2026年11月10日

QC基準を満たした最後の更新が送信されました

2026年11月4日

最終確認日

2026年11月1日

詳しくは

本研究に関する用語

その他の研究ID番号

  • 441

個々の参加者データ (IPD) の計画

個々の参加者データ (IPD) を共有する予定はありますか?

いいえ

IPD プランの説明

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

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