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Case Reports
. 2023 Aug;70(8):1394-1396.
doi: 10.1007/s12630-023-02440-3. Epub 2023 Mar 28.

Semaglutide, delayed gastric emptying, and intraoperative pulmonary aspiration: a case report

Sandra R Klein  1 , Ion A Hobai  2   3
Affiliations
Case Reports

Semaglutide, delayed gastric emptying, and intraoperative pulmonary aspiration: a case report

Sandra R Klein et al. Can J Anaesth. 2023 Aug.

Abstract
in English, French

Purpose: We report a case in which the use of semaglutide for weight loss was associated with delayed gastric emptying and intraoperative pulmonary aspiration of gastric contents.

Clinical features: A 42-yr-old patient with Barrett's esophagus underwent repeat upper gastrointestinal endoscopy and ablation of dysplastic mucosa. Two months earlier, the patient had started weekly injections of semaglutide for weight loss. Despite having fasted for 18 hr, and differing from the findings of prior procedures, endoscopy revealed substantial gastric content, which was suctioned before endotracheal intubation. Food remains were removed from the trachea and bronchi using bronchoscopy. The patient was extubated four hours later and remained asymptomatic.

Conclusion: Patients using semaglutide and other glucagon-like peptide 1 agonists for weight management may require specific precautions during induction of anesthesia to prevent pulmonary aspiration of gastric contents.

RéSUMé: OBJECTIF: Nous rapportons un cas dans lequel l’utilisation de sémaglutide à des fins de perte de poids a été associée à un retard de vidange gastrique et à une aspiration pulmonaire peropératoire du contenu gastrique. CARACTéRISTIQUES CLINIQUES: Un patient de 42 ans souffrant d’un œsophage de Barrett a subi une cinquième endoscopie gastro-intestinale supérieure avec ablation de la muqueuse dysplasique. Deux mois plus tôt, le patient avait commencé à recevoir des injections hebdomadaires de sémaglutide pour perdre du poids. Bien qu’à jeun depuis 18 heures et à la différence des évaluations lors des interventions antérieures, l’endoscopie a révélé un contenu gastrique important, qui a été aspiré avant l’intubation endotrachéale. Les restes de nourriture ont été retirés de la trachée et des bronches par bronchoscopie. Le patient a été extubé quatre heures plus tard et est demeuré asymptomatique. CONCLUSION: Les patients utilisant du sémaglutide et d’autres agonistes du peptide analog au glucagon-1 pour la gestion du poids pourraient nécessiter des précautions spécifiques lors de l’induction de l’anesthésie pour empêcher l’aspiration pulmonaire du contenu gastrique.

Keywords: GLP 1; adverse reactions; endoscopy; esophago-gastro-duodenoscopy; glucagon-like peptide 1; obesity.

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References

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