{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T12:39:12Z","timestamp":1791549552494,"version":"4.3.4"},"reference-count":79,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Glucagon\u2010like peptide\u20101 receptor agonists are known to delay gastric emptying; however, the association between glucagon\u2010like peptide\u20101 receptor agonist use and peri\u2010operative pulmonary aspiration risk is not known. This systematic review and meta\u2010analysis aimed to summarise the evidence on whether glucagon\u2010like peptide\u20101 receptor agonist exposure is associated with pulmonary aspiration or increased residual gastric content in fasted patients undergoing procedures requiring anaesthesia or sedation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched six databases for studies assessing peri\u2010operative pulmonary aspiration or residual gastric contents in fasted patients or volunteers who were using any form of glucagon\u2010like peptide\u20101 receptor agonist. Pooled odds ratios were estimated for each outcome using random effects meta\u2010analysis. Certainty of evidence for each outcome was assessed using the GRADE framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 9010 screened studies, 28 observational studies were included. In a meta\u2010analysis of nine studies involving 185,414 patients and 471 cases of pulmonary aspiration, glucagon\u2010like peptide\u20101 receptor agonist exposure was not associated with pulmonary aspiration (OR 1.04, 95%CI 0.87\u20131.25, low certainty of evidence). In a meta\u2010analysis of 18 studies involving 165,522 patients and 3831 cases of residual gastric contents, glucagon\u2010like peptide\u20101 receptor agonist exposure was associated with an increased risk of residual gastric contents despite appropriate fasting (odds ratio 5.96, 95%CI 3.96\u20138.98, low certainty of evidence). In a meta\u2010analysis of five studies involving 1706 patients and 208 cases of residual gastric contents, withholding at least one dose of glucagon\u2010like peptide\u20101 receptor agonist before a procedure was associated with lower odds of residual gastric contents (odds ratio 0.51, 95%CI 0.33\u20130.81, very low certainty of evidence).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Patients using glucagon\u2010like peptide\u20101 receptor agonists are at increased risk of presenting for anaesthesia with residual gastric contents, though the available evidence does not indicate that this translates to an increased risk of pulmonary aspiration.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/anae.16601","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T03:59:01Z","timestamp":1744689541000},"page":"846-858","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":62,"title":["Association between glucagon\u2010like peptide\u20101 receptor agonist use and peri\u2010operative pulmonary aspiration: a\u00a0systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0173-9927","authenticated-orcid":false,"given":"Jasmin","family":"Castrillon","sequence":"first","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siddharth","family":"Rele","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"Sumithran","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Translational Medicine, Monash University  Melbourne VIC Australia"},{"name":"Department of Endocrinology and Diabetes Alfred Health  Melbourne VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Hii","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmala","family":"Thuraisingam","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Spelman","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuong","family":"Phan","sequence":"additional","affiliation":[{"name":"Department of Critical Care The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Choong","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Dowsey","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0937-2412","authenticated-orcid":false,"given":"Cade","family":"Shadbolt","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Melbourne, St Vincent's Hospital Melbourne  Fitzroy VIC Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010022\u201002153\u2010x"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/DMSO.S387116"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/dom.14944"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/oby.23481"},{"key":"e_1_2_6_6_1","first-page":"1","article-title":"Are serious anesthesia risks of semaglutide and other GLP\u20101 agonists under\u2010recognized? 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